Activcare Orange

Allegation investigated: Resident sustained injuries due to lack of care

Licensing Program Analyst (LPA)Michelle Reed arrived at the facility to discuss the complaint allegation. Upon arrival, LPA met with Executive Director Vanessa Valencia. LPA toured the physical plant with Mrs. Valencia. Records were reviewed and interviews were also conducted. Resident #1(R1) was admitted into the facility on 10/17/22. Records reviewed disclosed that R1 was nonambulatory with Dementia. R1 also had aggressive behavior, sundowning and needed assistance with all ADL's. The narrative charting as well as staff interviewed disclosed that R1 was often agitated and aggressive towards staff and other residents. R1 was able to walk through the building but had very unstable gait and did have falls with bruising. R1 was also very difficult to redirect. Facility staff reached out to R1's doctor and responsible party and medication adjustments were made. R1 also had a 1:1 companion in place, during the day, to assist with behaviors. Based upon interviews conducted and records reviewed the allegation is unsubstantiated, meaning that although the allegation may have happened or is valid, there is not a preponderance of the evidence to prove that R1 sustained injuries due to lack of care. An exit interview was conducted with Vanessa Valencia and a copy of this report was provided. Unsubstantiatedthe state’s words, verbatim · CDSS document, Jan 6, 2023 · control 22-AS-20221229161124

Type of visit: Case Management - Incident

Licensing Program Analysts (LPAs) Kimberly Lyman and Alvaro Ramirez conducted an unannounced case management visit to follow up on an SOC 341 dated 12/05/2022. LPAs were greeted and granted entry into the facility and explained the reason for the visit. SOC 341 indicated Resident 1 (R1) reported being soiled over night as well as being denied assistance by Staff (S1). After the incident was reported, R1 was assessed and had no injuries. Facility investigated the incident and S1 was suspended pending investigation. S1 was terminated effective 12/12/2022. During the visit, LPAs toured the facility, interviewed Staff and attempted to interviewed R1 and facility Residents LPAs were unable to interview R1 due to the dementia diagnosis. Per physician report dated 04/28/2022, Resident is diagnosed with Lewy Body Dementia, Parkinson's disease and hearing loss. LPAs observed Residents eating lunch in the dining room and appeared well taken care of. LPAs reviewed and obtained pertinent documentation such as physician report, Staff records and Staff statements regarding the incident. No deficiencies noted during today's visit. An exit interview was conducted and a copy of this report was left at the facility.the state’s words, verbatim · CDSS document, Dec 14, 2022

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Edward Tapia made an unannounced required annual inspection at this facility. LPA met with Director Quality Assurance Elva Ledesma and Family Advisor Luciano Deleon and stated the purpose of this visit. The facility is a single-level structure divided into four wings and licensed for seventy-two non-ambulatory residents of which seventeen may be bedridden and fifteen may be on hospice. This facility offers Residential Care for the Elderly/Dementia. At about 11:25 am, LPA Tapia was granted entry after completing the Coronavirus 2019 (COVID 19) screening procedure. For this visit, LPA observed residents in care and staff members on duty. LPA toured the interior and exterior portions of the facility. Resident rooms were selected at random for inspection. Rooms that were selected for inspection were (202,204,205,303). Resident rooms were provided with furniture in good repair, clean linens, adequate storage space, and kept free of tripping hazards. Resident rooms had shared of restrooms. Resident restrooms were observed to be in good repair and provided with grab bars and hot water was measured between 105.8 degrees and 110.6 degrees Fahrenheit. LPA also notice handing washing signs throughout the facility. LPA Tapia notice PUB 475 posters posted in prominently locations. LPA was provided a report for smoke detectors and carbon monoxide alarms being tested on 07/14/2022. Facility met the minimum two-day supply of perishable and seven-day supply of non-perishable food stock requirements, cleaning supplies and sharp items were inaccessible to residents in care. Facility had adequate supplies of personal protective equipment in place. Fire extinguishers were observed to be charged and operational. For the exterior portion, facility had an outside patio with furniture in good repair; and grounds were free of tripping hazards. Kitchen was in good repair and in a separate room inaccessible to residents. Dining room was in good repair and seating arrangements are 2 persons per table. Facility also had a medication, maintenance, and laundry room all of which were in good repair. LPA Tapia reviewed the COVID 19 mitigation plan and Emergency Disaster plan of the facility. LPA discussed Assembly Bill 665 that requires a licensee of any adult care residential facility that has internet service to provide at least one internet access device, such as a computer, smart phone, tablet or other device, that: can support real-time interactive applications; is equipped with video conferencing technology, including microphone and camera functions; and is dedicated for client or resident use. For this visit, no deficiency was noted in areas observed. No advisory was issued today. LPA Tapia conducted an exit interview with Director Quality Assurance Elva Ledesma and copy of this report was explained and left at the facility.the state’s words, verbatim · CDSS document, Sep 16, 2022

Type of visit: Case Management - Incident

Licensing Program Analyst Michelle Reed arrived at the facility to conduct a case management visit. Upon arrival, LPA met with Administrator Elva Ledesma. The visit was conducted to check on the disposal of PPE at the facility. A tour of the physical plant was conducted inside and outside with Ms. Ledesma. During the tour LPA noted that trash as well as gloves and masks were stored in covered containers. LPA did not notice any trash in or around the parking lot. The facility is right behind OC Medical Center and shares an adjacent parking lot. OC Medical Center has a trash receptacle in their parking. The trash dumpster and staff parking lot for Activcare are in the back of the building. LPA noted that the dumpster was covered and trash bags were tied shut. There is also a covered trash can outside the exit to the parking lot where staff can dispose of their trash as needed. Elva Ledesma also stated that their Maintenance Director does conduct a routine check of the grounds looking for trash. No citations issued at the time of this visit. An exit interview was conducted and a copy of this report was provided to Ms. Ledesma.the state’s words, verbatim · CDSS document, Aug 8, 2022

Allegation investigated: Staff do not allow residents to enter their rooms Staff interfere with residents sleep Staff do not assist with incontinence care on a regular basis Staff do not reposition residents on a regular basis

Licensing Program Analyst Michelle Reed arrived at the facility to discuss the complaint allegations. Upon arrival, LPA met with Administrator Elva Ledesma. A tour of the facility was conducted. The residents present are located in the " Patriotic and Baseball" wings of the building. There were 2 caregivers and 2 LVNs present. LVNs are present on each shift to assist staff. Interviews were conducted and records were reviewed. LPA observed residents conducting activities. Two residents were asleep in chairs and another was in her room resting. Lunch was to be served so staff did not move the residents into their bedrooms. Naps are usually taken after lunch. Residents who are incontinent are changed every two hours or as needed. Staff interviewed stated that residents may go to their rooms when they want, however, some were fall risks, so they were kept in the living room/activity room for closer observation. Currently there is 1 resident who needs to be repositioned. She is also checked every two hours and sometimes more often. Based upon interviews and a review of records the allegations are unsubstantiated, meaning that although the allegations may have happened or are valid, there is not a preponderance of the evidence to prove that staff neglect and violate resident rights. An exit interview was conducted with Administrator Lesdesma and a copy of this report was provided. Unsubstantiatedthe state’s words, verbatim · CDSS document, Jan 5, 2022 · control 22-AS-20211228103358

The state marks this report as 3 pages; the online copy we transcribed has 1. You can request the full file from the county licensing office.

Type of visit: Required - 1 Year

On today’s date, Licensing Program Analyst (LPA) LPA Rosie Quiroz conducted an unannounced visit for the purpose of conducting a required annual inspection. LPA Quiroz was greeted and granted entry into the facility by Front desk Receptionist and met with Executive Director (ED) ED Elva Ledesma, and explained the nature of the visit. This facility is licensed to provide services to Dementia Residents, age range 60 and over, and approved for seventy-two (72) Non-Ambulatory Residents, of which seventeen (17) may be bedridden and has a hospice waiver for fifteen(15) residents. This facility is approved for secured perimeter egress. ED Elva Ledesma has an Administrator Certificate with expiration date of 10/7/2021 . On or about 10:53am LPA Quiroz along with ED Ledesma toured the inside and outside of facility. All staff working at facility were observed to be wearing face masks upon arrival to facility. There are twelve (12) residents in care and there are no active COVID-19 cases. During today's inspection visit, LPA Quiroz observed residents participating in Yoga excercise activity and making Birthday hats . Residents appeared to be clean and well taken care of. LPA Quiroz observed required department postings in the facility as well as hand washing signs in the restrooms. All restrooms observed to have ample soap/sanitizer and appeared clean. LPA Quiroz inspected residents’ bedrooms and appeared clean and sanitary with all required components. LPA Quiroz observed a check in station in the main entry of the facility. Facility is taking temperatures daily and documenting results. LPA Quiroz observed the emergency disaster and evacuation plan. Facility has back-up emergency food and water supply as well as PPE supplies. LPA Quiroz toured the outside of the facility and observed seating area with table and chairs for resident’s enjoyment. Facility has completed the LIC 808 Mitigation plan, which was approved by LPA Micah Martinez on 2/9/2021. CONTINUED ON NEXT PAGE... During today's inspection visit, LPA Quiroz reviewed five of twelve resident records. Based on the observation made during today’s visit, no deficiencies were noted today per Title 22 Division 6 of the California Code of Regulations. This report was reviewed with ED Elva Ledesma, and a copy of this report was provided to ED Ledesma at exit.the state’s words, verbatim · CDSS document, Sep 29, 2021