A & A Care and Wellness

Allegation investigated: R1's medication not given according to the physician's directions. Reporting Requirements.

Licensing Program Analyst (LPA) Rayshaun Nickolas made an unannounced visit to the facility to deliver the finding on the above allegations. LPA met with caregiver Tyeshia Jones, and explained the purpose of the visit. The investigation included a file reviews and interviews with relevant parties. Allegation #1 "R1's medication not given according to the physician's directions". The allegation alleged that the facility failed to administer resident #1's (R1's) medication as prescribed by R1's physician. LPA Nickolas' interview with the Licensee revealed that the Licensee confirmed that R1 missed doses of their medication, but it was not the facility's fault. The Licensee stated that there was an issue with the physician's office sending the medication to the pharmacist. LPA Nickolas's interview with staff #1 (S1) revealed that they deny this allegation. LPA Nickolas' interview with staff #2 (S2) revealed that R1's medical insurance carrier would not approve the prescribed medication, so the facility could not refill it. LPA Nickolas interview with R1 revealed that they could not patricipate in the interview process. The finding is Unsubstantiated. There is no evidence or witnesses to corroborate the allegation. Unsubstantiated Allegation #2 "Reporting Requirements". The allegation alleged that the facility failed to report resident #1’s (R1’s) medication errors. LPA Nickolas’ interview with the Licensee revealed that the Licensee stated they sent a fax about the medication error to the Community Care Licensing Division (CCLD) via fax. The Licensee stated they also reported this incident to another agency. LPA Nickolas’ file review revealed no record of this incident reported to our agency. However, the Licensee has a history of reporting unusual injuries/incidents at the facility before and after this incident. The finding is Unsubstantiated. There is no evidence or witnesses to corroborate the allegation. A finding of Unsubstantiated means although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation did or did not occur. An exit interview was conducted and copy of this report was provided.the state’s words, verbatim · CDSS document, Oct 23, 2023 · control 56-AS-20221122161723

Allegation investigated: Resident is being over medicated. Residents were left alone in the facility. The facility is requiring a client to hide when guests come to the facility. The staff are not properly logging medications in the medical record (MAR). The staff is not able to communicate with the residents based on a language barrier. The staff is not following resident’s special diet.

Licensing Program Analyst (LPA) Rayshaun Nickolas made an unannounced visit to the facility to deliver the finding on the above allegations. LPA met with caregiver Tyeshia Jones, and explained the purpose of the visit. The investigation included a file reviews and interviews with relevant parties. Allegation #1: “Resident is being over medicated.” The allegation alleged that the Licensee requires their staff to administer pro re nata (PRN) medication to resident #1 (R1) when the PRN is not required. LPA Nickolas, with staff #1 (S1) and staff #2 (S2), revealed that they denied this allegation. LPA Nickolas’ interview with R1 revealed that they could not participate in the interview process. LPA Nickolas' interview with resident #2 (R2) revealed that they denied this allegation. The finding is Unsubstantiated. There is no evidence or witnesses to corroborate the allegation. Allegation #2” Residents were left alone in the facility”. The allegation alleged that the licensee left residents alone in the facility without supervision. Unsubstantiated LPA Nickolas' interview with the licensee revealed that they denied this allegation. LPA Nickolas' interview with S1 and S2 revealed that they denied this allegation. LPA Nickolas' interview with R1 revealed that they could not participate in the interview process. LPA Nickolas' interview with R2 revealed that they could not provide any information about this allegation. The finding is Unsubstantiated. There is no evidence or witnesses to corroborate the allegation. Allegation #3 “The facility is requiring a client to hide when guests come to the facility”. The allegation alleged that the licensee had instructed staff to hide resident #3 (R3) when visitors came to the facility. LPA Nickolas' interview with the licensee revealed that they denied this allegation. LPA Nickolas' interview with S1 and S2 revealed that they denied this allegation. LPA Nickolas' interview with R2 revealed they could not provide information about this allegation. LPA Nickolas' interview with R1 revealed that they could not participate in the interview process. The finding is Unsubstantiated. There is no evidence or witnesses to corroborate the allegation. Allegation #4 “The staff are not properly logging medications in the medical record (MAR)”. The allegation alleged that the staff was not trained to dispense medication. Therefore, the owner completes the medication administration record (MAR) later. LPA Nickolas's interview with the licensee revealed that they denied this allegation. LPA Nickolas' interview with S1 and S2 revealed that they denied this allegation. On May 1, 2023, a medication audit was conducted by LPA Nickolas' during the initial complaint visit. LPA Nickolas' medication audit of all residents in care revealed no discrepancies. LPA Nickolas's medication audit also revealed that the medication administration records. The finding is Unsubstantiated. There is no evidence or witnesses to corroborate the allegation. Allegation #5 “The staff is not able to communicate with the residents based on a language barrier”. The allegation alleged that a facility staff member could not communicate with residents in care because of a language barrier. LPA Nickolas’ interview with the licensee revealed that they denied this allegation. LPA Nickolas’ interview with S1 and S2 revealed that they denied this allegation. LPA Nickolas’ interview with R2 revealed that they denied this allegation. LPA Nickolas' interview with R1 revealed that they could not participate in the interview process. The finding is Unsubstantiated. There is no evidence or witnesses to corroborate the allegation. Allegation #6 “The staff is not following resident’s special diet”. The allegation alleged that R2 has a special diet that the facility is not adhering to. LPA Nickolas’ interview with the licensee revealed that they denied this allegation. LPA Nickolas interview with S1 and S2 revealed that they denied this allegation. LPA Nickolas' file review confirmed that R2 has special diet. However, there is no evidence that the facility staff is not adhering to R2's special diet.The finding is Unsubstantiated. There is no evidence or witnesses to corroborate the allegation.the state’s words, verbatim · CDSS document, Oct 23, 2023 · control 56-AS-20230427101245

Allegation investigated: The facility does not have enough staff to care for the residents needs. The staff is working without a background clearance. Facility staff are not qualified. The facility is not providing meals of nutritional value. The facility does not have the required amount of food based on regulation. The residents mediations are not secure

Licensing Program Analyst (LPA) Rayshaun Nickolas made an unannounced visit to the facility to deliver the finding on the above allegations. LPA Nickolas met with Licensee Helen Akopyan and explained the purpose of the visit. The investigation included a facility tour, file reviews, and in interview with relevant party. Allegation #1 “The facility does not have enough staff to care for the resident’s needs”. The facility does not have enough staff to care for the resident’s needs”. The allegation alleged that the facility does not have enough staff. The allegation alleged that the facility is a level IV (4) facility and should have at least two (2) staff members per shift but never two (2) staff are available per shift. LPA Nickolas' interview with the Licensee revealed that the facility currently has four (4) employees on staff and three (3) clients in care. The Licensee stated that there is one (1) staff per shift. LPA Nickolas' file review confirmed the facility's number of employees and clients. LPA Nickolas' file review of the California Code of Regulations (CCR) revealed that the facility had not violated regulations and had enough employees working there. The finding is Unsubstantiated. There is no evidence or witnesses to corroborate the allegation. Unsubstantiated Allegation # 2 “The staff is working without a background clearance”. The Reporting Party (RP) alleged that they did not apply nor a background check when hired. LPA Nickolas’ interview with the Licensee revealed that the former employee was provided an application; however, it was never returned to the Licensee. The Licensee stated that the former employee did have a criminal records clearance with the California Department of Social Services (CDSS) and was associated with the facility in the CDSS guardian background check system. LPA Nickolas’ file review revealed that the former employee had a criminal record clearance with CDSS and was associated to this facility in the CDSS guardian background check system. The finding is Unsubstantiated. There is no evidence or witnesses to corroborate the allegation. Allegation #3 “Facility staff are not qualified. The allegation alleged the Licensee is not checking anyone’s qualifications before hiring them. LPA Nickolas’ interview with the Licensee revealed that the Licensee has potential employees complete an application. The Licensee stated that an interview with the potential employee is conducted after the application is completed. The Licensee stated that the potential employee would complete a criminal records clearance with CDSS. The Licensee stated that all employees are trained continuously, and the Licensee provided the training records to LPA Nickolas. LPA Nickolas’ facility file review of the training records revealed that all employees had received 40 hours of on-site orientation in 13 various training topics. The employees have signed and dated acknowledging completion of training. LPA Nickolas facility file review revealed that employees have also received various certifications for training. The finding is Unsubstantiated. There is no evidence or witnesses to corroborate the allegation. Allegation #4 “The facility is not providing meals of nutritional value”. The allegation alleged that there are no meal plans and that only frozen foods and bread are purchased. The allegation alleged that none of the clients in the home get vegetables, fruits, or home-cooked meals. LPA Nickolas' interview with the Licensee revealed that the facility does have a menu. However, facility staff does not use the food menu to prepare meals. The Licensee stated that facility staff prepares meals for the clients based on what the clients prefer to eat. The Licensee stated that the facility staff always provides the clients with healthy options and integrates salads and low-carbohydrate options. LPA Nickolas' facility food audit revealed that the facility has plenty of fresh, frozen, and canned fruits and vegetables. LPA Nickolas' observed that the facility is offering clients a variety of foods to meet the client's nutrition needs. The finding is Unsubstantiated. There is no evidence or witnesses to corroborate the allegation. Allegation #5: “The facility does not have the required amount of food based on regulation”. The allegation alleged that the facility’s refrigerator is empty, and no one cooks for the clients. LPA Nickolas' facility food audit revealed the facility had more than a seven (7) day supply of non-perishable foods and a two (2) day supply of perishable food. The finding is Unsubstantiated. There is no evidence or witnesses to corroborate the allegation. Allegation #6 “The residents’ mediations are not secure. LPA Nickolas’ interview with the Licensee revealed that the medications are locked in a locked cabinet. During LPA Nickolas’ facility tour, the Licensee showed LPA Nickolas where the medications were stored. LPA Nickolas’ observed the Licensee unlock the secured filing cabinet where the medications were stored. The finding is Unsubstantiated. There is no evidence or witnesses to corroborate the allegation. A finding of Unsubstantiated means although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation did or did not occur. An exit interview was conducted and copy of this report was provided.the state’s words, verbatim · CDSS document, May 1, 2023 · control 56-AS-20230427101245

The state marks this report as 4 pages; the online copy we transcribed has 3. You can request the full file from the county licensing office.

Type of visit: Case Management - Other

Licensing Program Analyst (LPA) Javier Prieto arrived to the facility to conduct a case management visit related to the passing of resident #1 (R1). R1 passed away on 05/20/22. Facility reported the incident to the Licensing office within the required time frame. LPA Prieto met with Helen Akopyam, Administrator, and gathered additional documentation. All parties involved were notified of R1s passing and previous medical condition. Additional copies of incident reports and subsequent passing were provided during today's visit. LPA Prieto conducted an exit interview, in which LPA Prieto and administrator Akopyam, signed this report and a copy was left with the facility.the state’s words, verbatim · CDSS document, May 27, 2022

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Rayshaun Nickolas conducted an unannounced visit to the facility. The purpose of the visit was to conduct a required annual inspection, with an emphasis on infection control due to the COVID-19 pandemic. LPA Nickolas arrived and met with Administrator, Helen Akopyan. LPA Nickolas was asked to sign-in and provide temperature reading upon arrival. The administrator confirmed that there are currently no cases/exposures of COVID-19 within the facility. During the inspection, LPA Nickolas conducted a tour of the facility and made observations pertaining to the facility's infection control measures and other health and safety concerns. LPA Nickolas observed appropriate postings throughout the facility, including hand-washing etiquette, face coverings, and COVID-19 symptoms postings. The facility was also equipped with sufficient hand hygiene supplies, sufficient cleaning/disinfecting provisions, and a supply of Personal Protective Equipment (PPE). LPA observed that the facility staff were wearing face coverings. The facility has a designated infection control lead person who has been tasked with tracking all COVID-19 cases and/or suspected cases, ensuring PPE supplies are maintained, cleaning and disinfection provisions are in adequate quantities, and that staff are trained in the facility's infection control measures. The facility has a plan in place which follows Community Care Licensing Division guidelines for COVID-19 testing, isolating/quarantining residents, and properly caring for residents with COVID-19 positive results and/or exposures. The facility also has a plan in place to monitor residents regularly for any changes in condition and to subsequently notify the resident's physician and emergency personnel in the event the resident presents any COVID-19 symptoms. LPA discovered staff working at the facility that is not criminal record cleared. Based on observations made during today’s inspection, one deficiency was cited per Title 22, Division 6, of the California Code of Regulations. An exit interview was conducted where this report was discussed, and a copy of this report was provided to Akopyan at the conclusion of the inspection..the state’s words, verbatim · CDSS document, May 16, 2022