Absolute Desert Care I

Type of visit: Case Management - Other

Licensing Program Analyst (LPA), Stephanie Martinez, conducted an unannounced visit to the facility, due to the closure of Absolute Desert Care II, to deliver the findings of the investigation into complaint #18-AS-20230323131654. The LPA met with Sandie Lapuz, Caregiver, and spoke with Administrator, Channe Carlos, over the phone. Carlos was notified of the purpose for the visit.the state’s words, verbatim · CDSS document, Oct 30, 2023

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Kathleen Banrasavong arrived unannounced to conduct an annual inspection. Upon arrival LPA was greeted by facility staff and granted entry. LPA began inspection with introduction and visit purpose. Upon arrival LPA learned that five (5) clients live at this facility. There were three (3) staff members present. Client Records/Incident Reports/Clients Rights Information: LPA reviewed client records. Five (5) records were reviewed. LPA reviewed for identification and emergency information, admission agreement, medical assessment, and TB test results, needs and service plans, placement, functional assessment, centrally stored medication/destruction records, safeguard for personal property/valuables, and personal rights notification. Personnel Records/Training/ Staffing/ Administration: LPA reviewed employee records. Three (3) records were reviewed. LPA reviewed employee records for first aid certification, criminal record clearance or an exemption, health screening and TB test results, employee rights, training verification, and current administrative organization. Channe Carlos, Administrator’s certificate expiration date is 07/19/2020. (Continued on LIC809C) (Continuation from LIC809) Food Service: Food prep areas are clean and organized. Food supply meets the requirement of one (1) week supply of nonperishable and two (2) day supply of perishables. Emergency food and water supply is present. There is a locked location for sharps in the kitchen. Physical Plant and Safety of Environment/Operational Requirements: LPA toured the facility inside and outside. LPA observed the facility to be clean and in good repair. The facility is maintained at 76 degrees for the client’s comfort. Lighting is sufficient for safety. Water temperature measured 108.0 degrees F. Laundry is done in the designated laundry room. There is a locked cabinet for storing laundry soap and other chemicals. All outdoor and indoor passageways are free of obstruction. Emergency lighting is available. There is a telephone working at this location. LPA dialed the facility’s landline number, which rang and was operable. The LIC 610, emergency disaster plan is maintained. There are no firearms at this facility. There is one (1) secured fireplace at this facility. There is a secured pool at the facility, with a 5-foot locked gate. There are two (2) gates that have a self-latching lock on the northwest and northeast side of the house. The facility performed their last fire and emergency drills on August 05, 2023. LPA reviewed the facility’s last disaster drills, which met the department's requirements. LPA observed emergency supplies and first aid with the required components. Infection Control: The LPA observed the hand washing stations in the facility restrooms and kitchen had hand hygiene supplies and hand washing signs. LPA observed PPE equipment and cleaning supplies to do regular cleaning of the facility. LPA reviewed the facility's infection control plan which met department requirements. LPA reviewed staff records and found that all staff had infection control training. (Continued on LIC809C) (Continuation from LIC809C ) Medications/Health Related Services/Incidental Medical Services: The medications are centrally stored. There is a locked cabinet allocated for medication storage. Centrally stored medication and destruction logs are maintained separately. LPA reviewed medication logs and observed if they were dispensed accurately. LPA made observation throughout the inspection process to assess if the facility remains in conformity with the State Fire Marshall regulations. LPA observed nine (9) dual fire alarms and carbon monoxide detectors. The caregivers tested the smoke alarms and carbon monoxide alarms on site. There is two (2) fire extinguisher on site, date last recharged was 07/19/2023. Pursuant to the Title 22 of The California Code of Regulations Division 6, there is one (1) type A deficiency observed. Per CCR 87355 (e) All individuals subject to a criminal record review pursuant to Health and Safety Code Section 1569.17(b) shall prior to working, residing or volunteering in a licensed facility. This requirement was not met by S(1) not having DOJ clearance. The Resident Care Manager states that S(1) will not return until a DOJ background clearance is completed. POC was cleared before LPA left the facility. An exit interview was conducted, this LIC 809 was reviewed with, a copy of this report and appeal rights was provided to the Resident Care Manager, Viridiana Cisneros as evidenced by her signature.the state’s words, verbatim · CDSS document, Aug 25, 2023

The state marks this report as 7 pages; the online copy we transcribed has 4. You can request the full file from the county licensing office.

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA), Chinwe Nwogene made an unannounced visit to the facility to conduct an annual inspection focused on infection control. LPA was greeted and granted entry by House Manger, Viridiana Cisneros who was informed of the purpose of the visit. At the time of visit there was 2 staff and 5 residents present. The facility currently has zero positive or suspected Covid-19 cases. During today's visit, LPA toured the facility inside and out with Viridiana and made observations regarding the infection control measures that the facility has implemented. LPA observed Covid-19 postings posted throughout the facility. The facility has an adequate amount of hand hygiene supplies (soap, hand sanitizer and paper towels) in all restrooms. LPA observed an adequately secured pool within the premises. LPA was informed that no weapons or ammunition is maintained at the home. The facility has a plan in place to monitor residents regularly for any changes in condition, which includes daily temperature checks. The Facility will contact the resident's physician should there be any event of COVID-19 related illnesses. The facility has a designated infection control lead. The facility also cleans and disinfects the highly touched surfaces during each shift, and as needed. LPA observed PPE supplies. During the visit LPA observed an individual not fingerprint cleared residing in the property. The individual was identified as the administrator’s sister. The individual stated she usually visits the administrator during the weekends but just arrived to the facility yesterday. LPA spoke to Administrator, Channe Carlos on the phone about the citation and plan of correction. Therefore, based on the observations made during today’s visit, the following deficiency was cited per Title 22, Division 6 of the California Code of Regulations. See LIC 809D. An exit interview was conducted, and this reported was provided along with LIC421BG and appeal rights.the state’s words, verbatim · CDSS document, Aug 8, 2022

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Anna Bueno made 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 Bueno met with caregiver Viridiana Cisneros. Cisneros confirmed that there are currently no cases or exposures of COVID-19 within the facility. LPA was not screened upon entry into the facility nor asked to use a hand sanitizer/hand wash. During the inspection, LPA Bueno conducted a brief tour of the facility and made observations pertaining to the facility's infection control measures. The facility was also equipped with sufficient hand hygiene supplies and sufficient cleaning/disinfecting provisions. LPA Bueno also observed that staff members were properly fitted with face coverings. The facility has a plan in place which follows Community Care Licensing Division guidelines for COVID-19 testing, isolating/quarantining clients, and properly caring for clients with COVID-19 positive results and/or exposures, however the LIC808, Covid-19 Mitigation Plan report, will have yet to be submitted by administrator Carlos. The facility monitors residents regularly for any changes in condition and to subsequently notify the resident's physician and emergency personnel in the event the client presents any COVID-19 symptoms. LPA Bueno observed no health and safety concerns at the time of visit. Based on observations made during today’s inspection, no deficiencies were cited per Title 22, Division 6, of the California Code or Regulations. Technical Advisories were provided for LIC808 submission and ensuring at least a 30 day supply of Personal Protective Equipment (PPE) is kept on hand and accessible to staff and residents. An exit interview was conducted where this report was discussed and a copy of this report was also provided to Cisneros at the conclusion of the inspection.the state’s words, verbatim · CDSS document, Aug 19, 2021

Allegation investigated: Facility staff failed to cross report as required by law.

Licensing Program Analyst (LPA) Jennifer Semin made an unannounced visit to the facility to deliver the final complaint investigation report. LPA met with Viridiana Cisneros and spoke with Licensee Channe Carlos via telephone. The investigation consisted of interviews with staff, resident and relevant party. Interviews revealed that the licensee admitted to being made aware of an incident that may have occurred and was reported by the Resident 1's (R1) responsible party and did not submit reports to required agencies, including the local ombudsman, the corresponding licensing agency, and the local law enforcement agency. Based on interviews the above allegations are SUBSTANTIATED. A finding that the complaint is SUBSTANTIATED means that the allegations are valid because the preponderance of the evidence standard has been met. Citation will be issued, see LIC9099D for details. An exit interview was conducted where this report was discussed with Channe Carlos via telephone and provided to Viridiana Cisneros . Substantiatedthe state’s words, verbatim · CDSS document, Aug 18, 2021 · control 18-AS-20190926112814

From the deficiency page — Deficiency type: Type B · Section cited: CCR 87211(c) · Plan of correction due date: Aug 18, 2021

REPORTING REQIREMENTS: Any suspected physical abuse that does not result in serious bodily injury of an elder or dependent adult shall be reported to the local ombudsman, the corresponding licensing agency, and the local law enforcement agency within twenty-four (24) hours. This requirement was not met as evidence by: the licensee admitted to being made aware of an incident that may have occurred and was reported by the Resident 1's (R1) responsible party and did not submit reports to required agencies. This poses a health and safety risk to residents in care.the state’s words, verbatim · CDSS document, Aug 18, 2021

Plan of correction: Licernsee shall read regulation 87608 in it's entirety,train staff on this regulation and submit a statement of understanding and training log to CCL by the POC due date of 8/19/2021.

Allegation investigated: Facility staff physically abused resident.

Licensing Program Analyst (LPA) Jennifer Semin made an unannounced visit to the facility to deliver the final complaint investigation report. LPA met with Viridiana Cisneros and spoke with Licensee Channe Carlos via telephone. The investigation consisted of interviews with staff, residents and relevant parties. Interviews with residents revealed that although Resident 1 stated staff physically abused them, Residents 2-5 stated they have never been physically abused by any staff nor witnessed any staff physically abusing any resident. Staff 2 and Staff 3 deny physically abusing any residents nor have they witnessed any staff physically abusing any residents. Staff 1 was unable to be interviewed due to three unsuccessful attempts to contact Staff 1. LPA confirmed that Resident 1 did not have a roommate nor were there any witnesses to cooperate the allegation that staff physically abused resident. Based upon interviews and information gathered, and although the allegations may have happened or are valid, there is not a preponderance of evidence to prove the alleged violations did or did not occur, therefore the allegations are UNSUBSTANTIATED at this time. An exit interview was conducted where this report was discussed with Channe Carlos via telephoneand provided to Viridiana Cisneros Unsubstantiatedthe state’s words, verbatim · CDSS document, Oct 3, 2019 · control 18-AS-20190926112814

From the deficiency page — Deficiency type: Type A · Section cited: CCR 87468.2(a)(8) · Plan of correction due date: Oct 4, 2019

ADDITIONAL PERSONAL RIGHTS OF RESIDENTS IN PRIVATELY OPERATED FACILITIES: In addition to the rights listed in Section 87468. 1. Personal Rights of Residents in All Facilities, residents in privately operated residential care facilities for the elderly shall have all of the following peraonal rights: To be free from neglect, financial exploitation, involuntary seclusion, punishment, humiliation, intimidation & verbal, mental, physical or sexual abuse. This requirement is not met as evidenced by: Interviews conducted corroborated that the bruise on R1 was a result of abuse.the state’s words, verbatim · CDSS document, Oct 3, 2019

Plan of correction: Licensee shall read egulations 87466.2 in its entirety and submit a statement of understanding and a staff training log to CCL by the POC due date of 10/4/2019.

From the deficiency page — Deficiency type: Type A · Section cited: CCR 87468.1(a)(3) · Plan of correction due date: Oct 4, 2019

PERSONAL RIGHTS OF RESIDENTS IN ALL FACILITIES. Residents in all residential care facilities for the elderly shall have all the following personal rights: To be free from punishment, humiliation, intimidation, abuse, or other actions of a punitive nature such as withholding residents' money or interfering with daily living functions such as eating, sleeping, or eliminating. This requirement is not met as evidenced by:Interviews conducted corroborated that the bed was elevated as a restraint so R1 could not get out of bed.the state’s words, verbatim · CDSS document, Oct 3, 2019

Plan of correction: Licensee shall read regulation 87468.1 in its entirety and submit a statement of understanding and a staff training log to CCL by the POC due date of 10/4/2019.