Pleasant Care Home

Allegation investigated: Staff yelled at resident.

On 11/8/23, Licensing Program Analyst (LPA) Lavinia Muscan arrived at the facility unannounced to deliver complaint findings into the allegations listed above and met with Administrator Lina Sepulveda. During the investigation, the Department conducted interviews and reviewed documentation pertinent to the investigation. The results of the investigation are as follows: **Report continued on 9099-C** Unsubstantiated Staff yelled at resident. The department conducted interviews with staff and residents and reviewed records to investigate the allegation. Interviews indicated that S1 admitted that on 10/14/23, S1 did speak a little loudly when S1 found R1 sliding down on R1s recliner. S1 thought R1 was injured and S1 panicked and said, “this is so dangerous, please don’t do this without asking for help”. Staff spoke a bit louder as R1 has trouble hearing. R1 has a habit of moving from bed to recliner during the night. R1 was not injured in the process. At the time of incident, on 10/14/23, it is not possible to say with certainty what a staff or resident may perceive as yelling, or what a particular tone of voice may sound like to someone else. Therefore, the department is not able to conclude if S1 was in fact intending to yell or did yell at a resident; or if S1’s voice was perceived as yelling. Therefore, the allegation is UNSUBSTANTIATED. A finding that the complaint is UNSUBSTANTIATED means that although the allegation may have happened or is valid, there is not a preponderance of the evidence to prove that the alleged violation occurred. Exit interview was conducted with Administrator and a copy of this report was provided to the facility.the state’s words, verbatim · CDSS document, Nov 8, 2023 · control 59-AS-20231017164751

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Lavinia Muscan arrived on 7/24/2023 to conduct the unannounced annual inspection. During today's annual inspection, the Compliance and Regulatory Enforcement Tool was used. LPA Muscan reviewed resident (2) and staff files (2). All resident files contained the required paperwork. All staff files contained the required paperwork and training. Staff have current first aid and CPR training. LPA Muscan and Administrator toured the facility together to ensure the health and safety of clients in care. The areas toured included client rooms, bathrooms, kitchen, common areas and outside area. Water temperature is within the required range of temperatures. In the areas toured, there were no health or safety violations observed. LPA requesting updated copy of LIC500, current liability insurance, and an updated copy of the LIC610E to be sent in to CCLD. No deficiencies cited. Exit interview conducted. A copy of this report was left at the facility.the state’s words, verbatim · CDSS document, Jul 24, 2023

Type of visit: Prelicensing

On 07/27/22, at 9:30am , Licensing Program Analyst (LPA) Talwinder Bains met with applicant, Lina Sepulveda to conduct a Pre- Licensing visit. LPA followed current Covid precautions- self screened, hand sanitized and surgical mask worn. The facility has a fire clearance for 6 non ambulatory residents. Applicant holds a current administrator certificate (#6023057740 with expiration date 12/06/2022 ). LPA conducted an inspection of the care home to ensure compliance with Title 22 regulations. There are 6 bedrooms for residents, 1 staff break room and 3 bathrooms .LPA observed facility to be properly furnished, including appropriate bedding and lighting in bedrooms. Bathrooms were in sanitary condition and properly maintained. LPA checked the kitchen area for the ability to prepare and store food. LPA observed cleaning products and other toxins to be locked away. LPA observed the area used for medication to be locked and inaccessible to residents. LPA observed smoke detectors and carbon monoxide detectors at the care home to be operational. Fire extinguisher and first aid kit are maintained and ready for emergency use. LPA inspected outside area and backyard area and found it clutter free. Pre-licensing passed and Component III was waived because Lina was licensee for RCFE for this location in the past. Applicant has satisfied all requirements in accordance to Title 22, California Code of Regulations. Application is pending and LPA will forward findings to the Centralized Application Bureau (CAB) for final review and approval. CAB will further contact applicant on final status of application. A copy of this report was provided to the facility. Exit interview conducted.the state’s words, verbatim · CDSS document, Jul 27, 2022

Type of visit: Office

On 07/22/2022, applicant/administrator participated in COMP II. Identification of the applicant and administrator was verified through interview questions based on photo ID and other identifying personal information. During COMP II, applicant and administrator confirmed the understanding of the California Code Title 22 Regulations. Signed LIC 809 with copy of photo ID have been obtained. During COMP II, CAB analyst confirmed Applicant/Administrator’s understanding of following areas: 1. Facility operation: License type, client/resident populations, and program 2. Admission Policies 3. Staffing requirements & Training 4. Restrictive/Prohibited Health Conditions 5. General provisions 6. Emergency Preparedness 7. Complaints & Reporting 8. Pre-licensing readinessthe state’s words, verbatim · CDSS document, Jul 22, 2022