The El Rey Home

Type of visit: Required - 1 Year

On 10/04/23 at 10AM, Licensing Program Analyst (LPA) D Panlilio arrived unannounced to conduct an annual required inspection. LPA met with administrator (ADM) and explained the purpose of the visit. LPA observed no residents at the facility. ADM stated she is converting the RCFE facility into an Adult Residential facility (ARF). Once she has her ARF license, she will work with Regional Center of the East Bay (RCEB) to get vendorized for 4 clients. LPA toured the facility including but not limited to the front entrance, screening station, kitchen, bathrooms, bedrooms and common areas. There is one central entry point for universal screening for staff, residents and visitors. A sign-in policy, visitor’s logs, no touch thermometer, additional face masks and hand sanitizers were observed at the screening station. Emergency Disaster Plan, Complaint poster, Personal rights, Cough/sneeze etiquette, proper hand-washing signs were observed posted in common areas. Facility has a sufficient 2-day perishable and 7-day non-perishable food supply. Facility has a 30-day supply of PPEs, paper, medications locked in cabinets. Comfortable temperature is maintained at 72 deg F. Hot water temperature was measured at 115 deg F. Facility has a mitigation plan in place and the infection control leader is the administrator. Inside and outside pathways were free of obstruction and fire hazards. Smoke and Carbon monoxide detectors were operational. Fire extinguisher was observed fully charged and last inspected on 10/22/23. LPA reviewed 1 staff and conducted 1 staff interview since there are no residents at the facility. No deficiency cited during visit. Exit interview conducted and a copy of this report provided.the state’s words, verbatim · CDSS document, Oct 4, 2023

Type of visit: Case Management - Other

On 09/29/23 at 2:10 PM, LPA D Panlilio conducted an unannounced required annual inspection at the facility. Upon arrival, LPA rang the door bell three times and knocked on the front door. There was no answer. LPA spoke with administrator on the phone who stated that the facility has no residents and that she has applied to convert the RCFE into an ARF facility. This is an attempted visit by LPA. Administrator was not available to sign the report today.the state’s words, verbatim · CDSS document, Sep 29, 2023

Allegation investigated: Staff abandoned resident at hospital Staff did not follow proper eviction procedures for resident

On 04/07/23 at 5PM, Licensing Program Analyst (LPA) D Panlilio conducted an unannounced complaint visit, met with administrator (ADM), conducted interviews and record reviews and delivered investigation finding to ADM. LPA explained the purpose of the visit with administrator. Allegation: Staff abandoned resident at the hospital Investigation Finding: SUBSTANTIATED On 04/07/23, LPA confirmed with administrator (ADM) that resident (R1) was transported by ambulance to the hospital on 04/03/23 where she was diagnosed and treated for constipation. ADM stated that she did not pick up R1 from the hospital because she has verbally communicated with R1’s authorized representative (POA) for 2 weeks after admission in early March that R1 needed to be relocated to another facility due to higher level of care needs. Continued on next page, LIC 9099-C Substantiated On 04/03/23. LPA confirmed with hospital staff (SW) that ADM did not pick up R1 who was waiting for pick-up at the hospital that day. Based on LPA’s observations and interviews which were conducted and record review(s), the preponderance of evidence standard has been met, therefore the above allegation(s) that staff abandoned resident at the hospital was found to be substantiated. Allegation: Staff did not follow proper eviction procedures for resident Investigation Finding: SUBSTANTIATED During visit, LPA confirmed with administrator (ADM) that she did not issue a written eviction notice to resident (R1) and her authorized representative (POA). ADM confirmed with LPA that R1’s personal belongings were removed from the facility on 04/03/23 and that R1 did not return to the facility from the hospital. Based on LPA’s observations and interviews which were conducted and record review(s), the preponderance of evidence standard has been met, therefore the above allegation(s) that staff did not follow proper eviction procedures for resident was found to be substantiated. Deficiencies are cited per Title 22 California Code of Regulations and listed on LIC9099D. 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.the state’s words, verbatim · CDSS document, Apr 7, 2023 · control 15-AS-20230403164320

From the deficiency page — Deficiency type: Type B · Section cited: CCR 87465(a)(2) · Plan of correction due date: Apr 28, 2023

A plan for incidental medical and dental care shall be developed by each facility. The plan shall encourage routine medical and dental care and provide for assistance in obtaining such care, by compliance with the following: (2) The licensee shall provide assistance in meeting necessary medical and dental needs. This includes transportation which may be limited to the nearest available medical or dental facility which will meet the resident's need. In providing transportation the licensee shall do so directly or make arrangements for this service. This requirement was not met as evidenced by staff not picking up resident from the hospital after treatment which posed a potential health & safety risk to resident in care.the state’s words, verbatim · CDSS document, Apr 7, 2023

Plan of correction: By POC due date, Administrator agreed to complete and submit to CCLD in-service staff retraining certifications on Incidental Medical and Dental Care to ensure compliance with Title 22 Section 87465 (a) (2).

From the deficiency page — Deficiency type: Type B · Section cited: CCR 87724(a) · Plan of correction due date: Apr 28, 2023

By POC due date, Administrator agreed to complete and submit to CCLD in-service staff retraining certifications on Incidental Medical and Dental Care to ensure compliance with Title 22 Section 87465 (a) (2). This requirement was not met as evidenced by staff not following proper eviction procedures for resident which posed a potential health & safety risk to resident in care.the state’s words, verbatim · CDSS document, Apr 7, 2023

Plan of correction: By POC due date, Administrator agreed to complete and submit to CCLD in-service staff retraining certifications on Incidental Medical and Dental Care to ensure compliance with Title 22 Section 87465 (a) (2).

Type of visit: Case Management - Other

On 10/27/22 at 1PM, a Component III presentation was also completed during the Pre-licensing inspection with the applicant. Common deficiencies and regulations were discussed with the applicant who understood and agreed to comply with Title 22 regulations in the operation of the residential care facility. The applicant was reminded of the statute that requires CCL to be notified within 5 business days of admitting their first resident. This notification may be done by phone, by mail, or by fax. This report was discussed with the applicant and a copy was provided.the state’s words, verbatim · CDSS document, Oct 27, 2022

Type of visit: Prelicensing

On 10/27/22 at 10:48AM, Licensing Program Analyst (LPA) Daisy Panlilio conducted an announced pre-licensing visit and met with Lorell Hamilton, applicant. LPA explained the purpose of the visit with the applicant. LPA toured the facility inside and outside including but not limited to resident's bedrooms, bathrooms, dining room, common living areas, kitchen, and outside patios. There is sufficient lighting around the facility. Resident's rooms were equipped with the proper furniture and lighting. Resident's rooms had proper bedding and linens for the residents. Bathroom was equipped with grab bars, nonskid mat, and hygiene items. Living room is equipped with the proper furniture for the residents. All toxins and sharp objects were locked. Passageways and hallways were free of obstruction. Fire extinguishers are observed fully charged. Dual smoke detectors/carbon monoxide were observed operational. Medication cabinet was locked and first aid kit was complete. All exit doors in the facility are equipped with auditory signals. Hot water temperature is measured at 118 degrees Fahrenheit. This is a brand new facility and perishable / nonperishable food supplies will be available when facility starts admitting residents. LPA observed the facility had the necessary posters in place (COVID signages, Ombuds & complaint poster). Component III was conducted with the applicant. No deficiencies were observed during inspection. LPA observed the facility is ready to be licensed. However, this report will be submitted to the central application unit (CAU) and a final review of the application will be conducted. This facility is not yet licensed and is subject to final approval by CAU. Additional requirements may still be required. Exit interview conducted and a copy of this report provided.the state’s words, verbatim · CDSS document, Oct 27, 2022