A Garden of Paradise Care Home

Type of visit: Case Management - Other

Licensing Program Analyst (LPA) Sabrina Calzada arrived unannounced to conduct a case management inspection following a recent updated fire clearance. LPA met with Oksana Doldier, Administrator, and explained purpose of inspection. LPA observed Administrator's spouse, Michael Doldier, also present at the facility and (1) resident resting in the common area. Currently, there are (4) residents and was advised (1) resident is under hospice care. The facility is licensed for (6) non-ambulatory residents and has an approved hospice waiver for (4). The updated fire clearance, issued 7/10/23, grants approval for (4) non-ambulatory residents to reside in (4) newly constructed private resident rooms and (2) non-ambulatory residents to remain living in (2) private resident rooms in the existing portion of the house, for a total of (6) residents. The prior fire clearance granted authorization for (1) shared resident room and (4) private resident rooms, all non-ambulatory. Administrator stated she has a resident that wishes to remain in a room in the existing building instead of moving to one of the newly constructed rooms and asked about increasing the total capacity from (6) to (8) residents. LPA explained the process to request an increase in capacity, referencing Health and Safety Code 1569.185(b)(1)(C). Administrator stated she would provide the Department with a completed LIC200, fee and updated facility sketch to reflect her request that a fire clearance be approved for (8) non-ambulatory residents, (4) residents residing the existing house and (4) residents residing in the newly added resident rooms. Administrator wishes to maintain the approved hospice waiver for (4) residents. LPA toured both the existing and new sections of the house and observed (3) residents to be present in the existing portion and (1) resident to be present in the new section. LPA did not observe any health and safety risk or personal rights violation during today's inspection. LPA observed newly installed fences, patio lights, patio furniture and umbrellas. There are no deficiencies issued on this report. Exit interview. Copy of report provided to the Administrator.the state’s words, verbatim · CDSS document, Jul 12, 2023

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Sabrina Calzada arrived unannounced to conduct a required annual. LPA met with Oksana Doldier, Administrator, and explained purpose of inspection. LPA observed Administrator's spouse, Michael Doldier, also present at the facility. LPA observed all (5) residents to be in their rooms at the start and duration of the inspection. Currently, there is (1) resident on hospice. The facility is licensed for (6) non-ambulatory residents and has a hospice waiver for (4). Prior to initiating today's inspection, LPA completed required COVID-19 Department protocols and confirmed the facility does not currently have any positive Covid-19 diagnoses. LPA was screened per Covid-19 precautionary measures upon entering the facility wore a surgical mask.. LPA and Administrator toured the interior and exterior of the facility including the common areas, resident bedrooms (5), (2) resident bathrooms, kitchen, laundry area and garage. Additionally, there are (4) unoccupied bedrooms, each with a full bathroom, that will be used as resident rooms once approval is granted by the fire department and licensing. Administrator stated she would like to increase the capacity from (6) to (8). Administrator to notify the Department when ready for fire inspection. LPA observed the facility to be clean, in good repair and odor-free. LPA observed the bathrooms to have the necessary grab bars, non-skid flooring, paper towels and 20-second hand-washing posters posted. LPA observed sufficient 2+day perishable and 7+day non-perishable supply of food, and locked sharps and medications in the kitchen and locked toxins to be secured nearby. LPA observed the inside temperature to be 77* F. Fire extinguisher was last serviced 2/4/2022 and facility conducts quarterly fire drills. Discussed vaccination status of residents/staff, eligibility for boosters and visitation protocols. Booster flyer provided. LPA observed multiple Covid posters as well as other required postings, including several Provider Information Notice (PIN) from the Department. Administrator to post updated PIN's to reflect recent guidance. and also a "Mask Required" poster outside the front entrance. cont on 809C(1).. 809C(1)...All staff is fingerprint cleared and associated and has current First Aid/CPR and other required training. LPA observed (1) unlocked gate from the inside back patio. There are no bodies of water or a pool. LPA observed a portion of the backyard fence to be on the ground due to the recent storms. LPA observed new fencing materials on site and Administrator stated it will be repaired as soon as the weather allows it. LPA observed (2) tables with seating and umbrellas as well as a cement circular walkway for walking. LPA observed RCFE Administrator Certificate # 60079637340- exp 12/12/2023 for current Administrator posted. LPA observed sufficient incontinent products and PPE on hand as well as an unopened First Aid kit, new flashlight and bottled water. LPA reviewed (3) of (5) resident files and found them to be complete and contain current documentation. LPA obtained an updated copy of LIC500, LIC308 and current liability insurance today. LPA printed an updated copy of the facility license to reflect an approved hospice waiver for (4) residents. There are no deficiencies issued during today's inspection. Exit interview with Administrator. Copy of report provided.the state’s words, verbatim · CDSS document, Jan 10, 2023

Type of visit: Required - 1 Year

Licensing Program Analysts (LPA) Talwinder Bains and Michael Hood arrived at the facility unannounced on 02/9/2022 to conduct a Required-1 Year Inspection utilizing the infection control domain. LPAs met with administrator, Oksana Doldier, and explained the purpose of the visit. Prior to initiating the annual inspection, LPAs completed required COVID-19 testing protocols, and self-screened for symptoms of COVID-19. LPAs wore the following Personal Protective Equipment (PPE) during today's visit: N-95 masks. LPAs and administrator toured facility together to ensure health and safety of residents in care. Areas toured include but are not limited to: common areas, five (5) resident bedrooms, two (2) resident bathrooms, garage, backyard, and storage. In the areas toured no immediate health, safety, or personal rights violations were observed. LPAs and administrator completed the infection control domain together and facility was found to be in substantial compliance at this time. No deficiencies are being cited as a result of today's inspection. Exit interview conducted and copy of report left at the facility.the state’s words, verbatim · CDSS document, Feb 9, 2022

Allegation investigated: Staff hit resident in care

LPA Lusby arrived on Friday July 30, 2021 to conclude a complaint investigation regarding the above allegation. Prior to 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 applied hand sanitizer before entering the facility and the following Personal Protective Equipment (PPE) was worn: N-95 mask. Throughout the course of the investigation, LPA interviewed staff, residents at the facility, relevant parties and reviewed R1's physician's report, hospital discharge paperwork, and needs and services plan. LPA learned that R1 has a diagnosis of Dementia and a history of hallucinations. (Continued on LIC9099-C) Unfounded Based on LPA's interviews and review of documentation, the preponderance of evidence standards was not met, therefore, the above allegation is found to be UNFOUNDED. An unfounded allegation means that the allegation was false, could not have happened and/or is without a reasonable basis. LPA Lusby conducted an exit interview. A copy of this report was left at the facility.the state’s words, verbatim · CDSS document, Jul 30, 2021 · control 25-AS-20210709080402

Type of visit: Required - 1 Year

Community Care Licensing (CCL) staff Mariya Melnichuk and Licensing Program Analyst (LPA) Wolter arrived at the facility unannounced on 07/19/2021 to conduct a Required-1 Year Inspection utilizing the infection control domain, LPA met with administrator, Oksana Doldier and explained the purpose of the visit. Prior to initiating the annual inspection, CCL staff and LPA completed required COVID-19 testing protocols, and self-screened for symptoms of COVID-19. CCL staff and LPA wore the following Personal Protective Equipment (PPE) during today's visit: surgical masks. Administrator took CCL staff and LPA's temperature upon arrival. CCL staff, LPA and administrator toured facility together to ensure health and safety of residents in care. Areas toured include but are not limited to: common areas, brief inspection of five (5) resident bedrooms, bathroom, garage, backyard, and additional building. In the areas toured no immediate health, safety, or personal rights violations were observed. LPA and administrator completed the infection control domain together and facility was found to be in substantial compliance at this time. No deficiencies are being cited as a result of todays inspection. Exit interview conducted and copy of report left at the facility. Administrator to send in updated copy of LIC 308 - Designation of Facility Responsibility, LIC 500 - Personnel Report, LIC 999 - Facility Sketch and current copy of Liability Insurance to update facility file to Community Care Licensing by 07/26/2021.the state’s words, verbatim · CDSS document, Jul 19, 2021

The state marks this report as 7 pages; the online copy we transcribed has 1. You can request the full file from the county licensing office.