Lake View Residential Care

Allegation investigated: Staff over medicated resident in care.

On 10/30/23, Licensing Program Analyst (LPA) Lavinia Muscan arrived at the facility unannounced to deliver complaint findings into the allegations listed above and met with Caregiver Oksana Gutsu. During the investigation, the Department conducted interviews and reviewed documentation pertinent to the investigation.The results of the investigation are as follows: Staff over medicated resident in care. Based on documents obtained and statements received, the department determined that there was insufficient evidence that any resident was overmedicated. Documents obtained show that all current medications were administered and logged correctly for residents per their doctor’s orders. Interviews indicated that staff were not overmedicating the residents and residents expressed no concerns with medication administration. Based upon the information obtained during investigation, the above 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 Caregiver and a copy of this report was provided to the facility. Unsubstantiated Staff allowed resident to push another resident in care. Staff allowed resident to yell at another resident in care. Based on interviews with staff and residents, the department determined that there was no one yelling or pushing residents in care therefore, the allegations are UNFOUNDED. A finding of unfounded means that the allegation is false, could not have happened and/or is without a reasonable basis. Staff is not able to care and supervise residents due to inadequate staffing. LPA has reviewed the facility schedule and observed that day shifts are covered by multiple staff. There is no evidence to support the allegation that needs are not being met due to staffing. LPA learned that there are at least 2 direct care staff available during the day. Residents indicated they feel that their needs are met, and LPA finds no evidence that the current staff level is insufficient. Therefore, the allegation is UNFOUNDED. A finding of unfounded means that the allegation is false, could not have happened and/or is without a reasonable basis. Staff did not ensure resident's dietary needs were met. Department conducted interviews with residents and staff to investigate this allegation. Interviews indicated that residents were happy with dietary services at facility and did not indicate any issues. Based on the record review for R1’s physician's reports and review of preadmission records, there are no dietary restrictions for R1, therefore the allegation is UNFOUNDED. A finding of unfounded means that the allegation is false, could not have happened and/or is without a reasonable basis. Staff did not provide authorized representative an admissions agreement during preadmissions. Based on records reviewed and interviews conducted, R1s responsible party did receive an Admission Agreement for R1 as required. From record review, the department observed a signed contract between the responsible party and the facility. Furthermore, the Licensee sent proof of sending the Admission Agreement to the RP twice, after it was handed to RP when signed, therefore, the allegation is UNFOUNDED. A finding of unfounded means that the allegation is false, could not have happened and/or is without a reasonable basis. Staff do not provide daily activities for residents in care. Based on interviews the facility does their best to accommodate each resident. Staff will have exercise sessions with the residents, the residents go on walks and the facility has books or arts for residents who enjoy reading or like arts and crafts. Additionally, residents' interviews did not indicate any problems with daily activities at the facility, therefore concluded that the residents can also watch TV if they choose, therefore the allegation is UNFOUNDED. A finding of unfounded means that the allegation is false, could not have happened and/or is without a reasonable basis. Staff does not ensure residents' room are clean and sanitized. Facility backyard is not appropriately equipped for outdoor use. Staff locked resident in bedroom. Staff do not dispose residents' urine in commode. Staff did not ensure resident's hygiene needs were being met. Based on interviews and observation, the department observed the facility to be well equipped for outdoor use. The facility has outdoor benches and a patio in the backyard. LPA toured the facility on 10/4/23 and did not find any dirty bedding, smells, or dirty rooms. Residents stated the caregivers clean the facility and take out trash frequently. It was observed that none of the commodes had any urine in them and that the commodes were clean and sanitized. It was also observed that none of the resident doors had any form of locking device on them. Additionally, staff and residents' interviews did not indicate any issues at the facility with cleanliness, sanitation, usage of outdoor/backyard areas, toilets, rooms, commodes and other area and found out that staff were assisting with resident's care needs per their service and care plans. Based on all this information, the allegations are UNFOUNDED. A finding of unfounded means that the allegation is false, could not have happened and/or is without a reasonable basis. Exit interview was conducted with Caregiver and a copy of this report was provided to the facility.the state’s words, verbatim · CDSS document, Oct 30, 2023 · control 59-AS-20230929120553

Allegation investigated: Facility staff did not safeguard resident's personal equipment

On 6/26/2023, Licensing Program Analyst (LPA) Lavinia Muscan arrived at the facility unannounced to deliver complaint findings into the allegations listed above and met with Caregiver Anatoliy Lutsuk. 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** Unfounded Facility staff did not safeguard resident’s personal equipment. On 5/17/22, R1 arrived at the facility. The medical supply service delivered R1’s medical equipment to the facility however on 5/18/22, R1 relocated to another licensed facility. When the medical equipment was delivered to this facility the licensee was out of town and there was some confusion on where R1’s equipment needed to be sent. On 10/27/22 the licensee and R1’s responsible party communicated with the medical supply company to ensure R1’s equipment was picked up from this facility and taken to R1’s new facility. Based on interviews conducted and records review, the licensee did safeguard resident’s medical equipment and made arrangements for R1’s medical equipment to be sent to the correct location. This agency has investigated the complaints alleging, facility staff did not safeguard resident’s personal equipment. 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. Exit interview with administrator. Copy of the report provided to facility.the state’s words, verbatim · CDSS document, Jun 26, 2023 · control 59-AS-20230306163754

Allegation investigated: Facility did not provide refund in a timely manner.

On 5/19/23, Licensing Program Analyst (LPA) Lavinia Muscan arrived at the facility unannounced to open and deliver complaint findings into the allegations listed above and met with Administrator Alex Lutsuk. 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** Substantiated Administrator acknowledged not paying refund to the family/responsible party of R1 who was deceased on 01/2/23. Based on regulation requirements (87507(g)(5)(A)(1) Admission Agreements), facility should have paid refund to R1's responsible party within 15 days after R1's death. As of May 19, 2023 the responsible party did not receive the refund of $5870.99. During today's visit, administrator stated payment was issued to R1's responsible party today May 19, 2023. Based on Title 22 regulations, licensee did not issue a refund to R1's responsible party within 15 days therefore, LPA finds that the allegation cited above is Substantiated. As a result of this investigation, LPA finds allegation to be (S) Substantiated - A finding that the complaint is Substantiated means that the allegation is valid because the preponderance of the evidence standard has been met. The deficiencies are cited on 9099-D, per Title 22 Regulations, Division 6. Exit interview with administrator. Appeals rights provided. Copy of the report provided to facility.the state’s words, verbatim · CDSS document, May 19, 2023 · control 59-AS-20230518124345

From the deficiency page — Deficiency type: Type B · Section cited: CCR 87507(g)(5)(A)(1) · Plan of correction due date: Jun 1, 2023

87507(g)(5)(A)(1)- Admission Agreements(g) Admission agreements shall specify the following: (5) Refund conditions(A) Facility policy concerning refunds, ...conditions under which a refund for ... fees will be returned in the event of a resident’s death, pursuant to Health and Safety Code section 1569.652… must be made to the individual...for the payment of the resident’s fees,... identified in admission agreement. 1569.652(c) A refund … within 15 days after the personal property is removed. This requirement was not as evidence by- facility did not pay the refund to R1s family/responsible party within 15 days of R1s death as required per regulation.the state’s words, verbatim · CDSS document, May 19, 2023

Plan of correction: Licensee agrees to submit a statement of understanding of this regulation and proof of payment of refund ($5870.99) to CCL by the POC date- 6/01/23.

Type of visit: Required - 1 Year

On 02/27/2023 Licensing Program Analyst (LPA) Lavinia Muscan, arrived at the facility unannounced to conduct an annual visit using the infection control tool visit. LPA met with Facility Caregiver, Vera Jitari and explained the purpose of the visit. Prior to initiating the visit, LPA completed required COVID-19 testing protocols, and a daily self-screening questionnaire for symptoms of COVID-19 infection to affirm no COVID-19 related symptoms. LPA ensured she used hand sanitizer shortly before entering the facility and the following Personal Protective Equipment (PPE) was worn: surgical mask. LPA and Caregiver toured facility together to ensure health and safety of residents in care. Areas toured include but are not limited to: common areas, resident bedrooms, outside area and common restrooms. Facility has a 2 day perishable and a 7 day non-perishable amount of food. In the areas toured no immediate health, safety, or personal rights violations were observed. LPA and Caregiver completed the infection control domain and facility was found to be in substantial compliance at this time. Facility has 6 residents 1 of which is on hospice. Administrator agrees to send in LIC500 and liability insurance. No deficiencies are being cited as a result of todays inspection. Exit interview conducted and copy of report left at the facility.the state’s words, verbatim · CDSS document, Feb 27, 2023

Type of visit: Required - 1 Year

Unannounced annual visit utilizing the infection control domain was performed by LPA Michael Smith. Contact with Anatoliy Lutsuk. A review of staff records on 4/8/22 indicates that all facility staff and other individuals who require caregiver background checks have received criminal record clearances. As a result of this visit, there were no deficiencies. However, 2 technical advisories were issued. Exit interview conducted.the state’s words, verbatim · CDSS document, Apr 8, 2022

Type of visit: Required - 1 Year

Unannounced annual visit utilizing the infection control domain was performed by LPA Michael Smith. Contact with Alex Lutsuk. A review of staff records on 12/28/21 indicates that all facility staff and other individuals who require caregiver background checks have received criminal record clearances. As a result of this visit, there were no deficiencies. However, 5 technical advisories were issued. Exit interview conducted.the state’s words, verbatim · CDSS document, Dec 28, 2021