Casa Amore Care Home

Allegation investigated: Staff do not assist resident with incontinence needs. Facility is not obtaining or distributing medication to resident.

On 09/22/2023 at 04:15 PM, Licensing Program Analyst (LPA) J. Sampair arrived unannounced to complete this investigation. Upon entering facility, LPA stated purpose of visit to staff member Evelyn Gordon. The Licensee arrived at approximately 4:30 PM. Over the course of the inspection, the LPA interviewed 3 residents, 3 staff members, reviewed records (including the resident roster, physician reports, care plans, MAR, centrally stored medication records, and medication lists), and inspected the facility inside and outside. Staff do not assist resident with incontinence needs. Based on data collected from interviews with Residents R1 and R2, staff were not assisting residents with incontinent needs in an adequate or a timely fashion. (Continued on 9099-C...) Substantiated (...Continued from LIC9099) Facility is not clean. Based on data collected from an inspection of the facility inside and outside by the LPA, the facility was and is currently clean. Financial abuse. Based on data collected from interviews with Residents R1 and R2, and a review of the records, staff was not financially abusing residents. Based on the data collected, although the allegations may have happened, or are valid, there is not a preponderance of evidence to prove the alleged violation did or did not occur, therefore the allegation is UNSUBSTANTIATED. Exit interview conducted with Licensee and a copy of this report provided via email. (...Continued from LIC9099) Based on the data collected, the allegation is false, could not have happened, and/or is without a reasonable basis, therefore, the allegations are UNFOUNDED. Exit interview conducted with Licensee and a copy of this report provided via email. (...Continued from LIC9099) Facility is not obtaining or distributing medication to resident. Based on data collected from interviews with Residents R1 and R2, and a review of the records, staff was not obtaining or distributing medication to residents adequately and/or in a timely fashion. Based on the data collected, the preponderance of evidence standard has been met; therefore, the above allegations have been found to be SUBSTANTIATED. 2 Type-B deficiencies have been cited per Title 22 California Code of Regulations (for details, refer to 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 with Licensee and a copy of this report provided via email.the state’s words, verbatim · CDSS document, Sep 22, 2023 · control 15-AS-20221012143303

From the deficiency page — Deficiency type: Type B · Section cited: CCR 87465(a)(5) · Plan of correction due date: Sep 29, 2023

87465 INCIDENTAL MEDICAL AND DENTAL CARE SERVICES: (a) ... provide for assistance in obtaining ... care by... (5) ... assist residents with self-administered medications as needed. This requirement is not met as evidenced by: Residents R1 and R2 stated, and their records supported their statements, that medications were not ordered and were not dispensed to them in a timely fashion.the state’s words, verbatim · CDSS document, Sep 22, 2023

Plan of correction: Licensee corrected deficiency.

From the deficiency page — Deficiency type: Type B · Section cited: CCR 87625(b)(3) · Plan of correction due date: Sep 29, 2023

87625 MANAGED INCONTINENCE: (b) ... the licensee shall be responsible for ... (3) Ensuring that incontinent residents are kept clean and dry ... This requirement is not met as evidenced by: Residents R1 and R2 stated, and their records supported their statements, that their adult diapers were not kept dry and clean in a timely fashion.the state’s words, verbatim · CDSS document, Sep 22, 2023

Plan of correction: Licensee corrected deficiency.

Type of visit: Case Management - Incident

On 09/22/2023 at 9:30 AM, Licensing Program Analyst (LPA) J. Sampair arrived unannounced for a case management visit concerning the 08/06/2023 COVID-19 outbreak at the facility. Upon entering facility, LPA stated purpose of visit to staff member Evelyn Gordon, who called Licensee Tina Camaclang. The Licensee arrived at approximately 10:00 AM. During the Inspection, the LPA interviewed the Licensee and reviewed documentation demonstrating that she had fully complied with reporting requirements for both the Department and for Contra Costa Public Health during the COVID-19 outbreak on 08/06/2023. Additionally, that she had properly cared for resident R1 when she was infected with COVID-19 and then when she was later hospitalized. No citations issued during this visit. Exit interview was conducted with Licensee. A copy of this report was provided via email.the state’s words, verbatim · CDSS document, Sep 22, 2023

Type of visit: Required - 1 Year

On 09/22/2023 at 9:30 AM, Licensing Program Analyst (LPA) J. Sampair arrived unannounced at facility for required annual inspection. Upon entering facility, LPA stated purpose of visit to staff member Evelyn Gordon who called Licensee Tina Camaclang. The Licensee arrived at approximately 10:00 AM. During the Inspection, the LPA inspected the facility inside and outside. LPA observed that the facility has a sufficient supply of food: 2 days perishable and 7 days nonperishable. A comfortable inside temperature of 72.5 degrees F was maintained. The facility was clean and the staff attentive to residents' needs. 2 Type-B citations were issued during the inspection (details in LIC809-D). The Required Annual Inspection is incomplete. The LPA will return unannounced to complete the inspection at a later date and time. Exit interview conducted with Licensee and a copy of this report was provided via email.the state’s words, verbatim · CDSS document, Sep 22, 2023

Type of visit: Required - 1 Year

On 9/16/22 at 1:00 PM, Licensing Program Analyst (LPA) J. Sampair conducted an infection control annual inspection. Upon arrival, LPA explained the purpose of the visit to staff. Administrator Tina Camaclang arrived shortly after LPA had toured the facility inside and outside. 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. The temperature inside of the facility was 75.2 and the hot water temperature was 110 degrees, which were in the safe temperature range. An administrator is on site at least the required 20 hour minimum each week to oversee business operations. Facility cited for 2 Type A and 1 Type B deficiencies (refer to LIC 809-D). Exit interview conducted, copy of Appeal Rights, and a copy of this report provided via emailthe state’s words, verbatim · CDSS document, Sep 16, 2022

Type of visit: POC

Licensing Program Analyst (LPA) James Sampair conducted a Plan of Correction (POC) inspection concerning the LIC809-D citation issued by LPA on 11/18/21. Upon arrival, LPA explained the purpose of the visit with Staff Member Jennyfe Lagana who showed that the fire extinguisher had been serviced 3 days after the POC in November. LPA then inspected the facility inside and outside. During the inspection, he observed that 2 of the 2 staff present were wearing face masks during visit and that they continue to follow the COVID-19 infection control measures in accordance with the Department and local public health requirements. The facility room temperature was maintained at a comfortable level and a certified administrator is on site more than the minimum of 20 hours a week to oversee proper business operation. The POC was cleared during this visit and no deficiencies cited during this visit. Exit interview conducted and a copy of this report was provided to the administrator.the state’s words, verbatim · CDSS document, Dec 9, 2021

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) James Sampair conducted an infection control annual inspection and explained the purpose of the visit with Staff Member Jennyfe Lagana. LPA observed 2 staff wearing face masks during visit. Facility has a completed COVID-19 mitigation plan (LIC 808) in place dated 01/21/2021. LPA discussed the LIC 808 with administrator and reviewed up-to-date COVID-19 infection control practices. LPA inspected the facility inside and outside. LPA observed screening station located near the front entrance with visitor's log, hand sanitizer, face masks, and no touch temperature probe. Routine symptom screening (+/-) temperature and symptom check is done at entry for all staff, residents, and visitors. LPA observed COVID-19 signages posted in common areas to promote hand washing, cough/sneeze etiquette, and physical distancing. Facility documents daily temperatures and COVID-19 symptom checks for staff and residents. Regular training has been conducted on infection prevention, symptoms, transmission and proper donning and doffing of PPE. All staff and residents are fully vaccinated. There were sufficient food and water supplies in the kitchen refrigerators/freezers. Emergency paper & PPE supplies were observed stored in the facility. Facility room temperature was maintained at a comfortable level and the hot water temperature was within the safe 105 to 120 degree range. A certified administrator is on site more than the minimum of 20 hours a week to oversee proper business operation. The Smoke and Carbon monoxide detectors were operational. Though the fire extinguisher was fully charged, it had not been serviced or replaced since March of 2019, which was much longer ago than the 12 months that it should have been, so they were cited for a Type B violation of Title 22. Exit interview was conducted and a copy of this report was provided to the administrator.the state’s words, verbatim · CDSS document, Nov 18, 2021

Allegation investigated: -Staff failed to abide by the Admission Agreement -Staff mishandled resident's personal belongings

On 10/28/2021 at 2:05PM, Licensing Program Analyst (LPA) Catherine Lin conducted an unannounced continuing complaint visit, meeting with the House Manager Genny Flores. Administrator was not at the facility and authorized Genny to sign and receive report. The Department conducted an investigation into the allegations per interviews and records review. Regarding the allegation that staff failed to abide by the Admission Agreement, the Department found that there was a financial dispute between the facility and the subject resident’s Responsible Party pertaining to a refund after the resident was moved out of facility past the 30 days notice given to facility. Upon review of the Admission Agreement, there was no language that addressed the specific circumstances of the issue. Unsubstantiated Per the allegation that staff mishandled resident’s personal belongings (a wheelchair and a red walker), the Department found that the facility had completed a detailed Personal Property and Valuables list that included the subject items at the time of move in, and it was provided to the subject resident’s Responsible Party - and signed off by the Responsible Party - at the time of move-out. There was insufficient information available to verify whether the correct wheelchair and walker had been returned. Although the allegations may have happened or are valid, there is not a preponderance of evidence to prove that the alleged violations occurred; therefore the allegations are Unsubstantiated. Exit interview conducted with House Manager Genny Flores and a copy of this report was provided.the state’s words, verbatim · CDSS document, Oct 28, 2021 · control 15-AS-20200703120450