Adorable Redbeam Home

Type of visit: Required - 1 Year

On 09/14/23, Licensing Program Analyst (LPA), Wendy Gibbs, conducted an unannounced annual visit using the full CAREs tool. LPA met with Administrator, Kadiguia Linayao, and explained the purpose of today's visit. The facility currently has five (5) residents, two (2) who are receiving Hospice Care. Structure/Physical Plant The facility is a single-story home in a residential neighborhood. It consists of 4 resident bedrooms, 3 bathrooms, kitchen, dining room, living area, outside shaded patio and attached garage. LPA and Administrator toured the facility. The front and backyard are landscaped and maintained. All walkways on the outside of the home were observed clean, clear, and free of obstructions, debris, and hazards. All gates exiting the backyard open easily. LPA did not observe any bodies of water on the premises. Bedrooms LPA inspected all resident bedrooms. All bedrooms were observed to have the required furniture including bed(s), nightstand(s) with lamps, dresser(s), chair(s), and adequate storage space for personal belongings. All beds had the required linens including a mattress cover, fitted sheets, blanket, comforter, and pillows. LPA observed an ample supply of bed linens in good repair. Bathrooms LPA inspected all bathrooms. Bathrooms were found to be within Title 22 regulation and were observed to be clean and operational. All bathrooms had nonskid matts and a shower chair available. The safety grab bars are secured to walls. LPA observed an ample supply of towels and hygiene products available for residents. The water temperature measured 120.4-degrees, 124.3-degrees, and 123.3-degrees Fahrenheit. LPA observed an ample supply of incontinent care supplies stored in resident rooms and an additional supply stored in the garage. Kitchen LPA inspected the kitchen and found it to be clean and sanitary. All appliances were observed to be in good working repair. LPA observed a 3-day supply of perishable foods and a 7-day supply of nonperishable. LPA observed an ample supply of cutleries, pots, and pans in good repair. All sharps are secured in a locked drawer and are inaccessible to residents. All cleaning supplies are stored under the sink and are inaccessible to residents. The water temperature measured 123.4-degrees Fahrenheit. Common Rooms LPA inspected all common rooms. The living areas had ample seating for all resident. Puzzles, games, and activities were observed in the living room and dining room. The dining room has a large rectangular table and chairs to accommodate all residents. LPA observed a fireplace that was screened and inaccessible to residents. All walkways were observed to be clean, clear, and free of obstructions and hazards. All rooms were maintained at a comfortable temperature. All rooms were observed to have ample lighting. Medications LPA reviewed the medications, Medication Administration Record (MAR), and medication destruction log for three (3) resident's. Three out of three resident’s MARs and medication are consistent with properly documented records. All medications were observed in their original containers. Centrally stored medications were observed secured in a locked cabinet in the office area. Safety LPA observed a fully charged fire extinguisher, mounted on the wall at the kitchen entrance, last serviced on 12/21/22. The last emergency drill was conducted on 08/19/23. Smoke detectors and carbon monoxide detectors are operable. The facility has a working landline telephone. LPA observed all required signs and documents posted throughout the facility. LPA inspected the First Aid kit and found it had the required items. File Review & Interviews LPA reviewed all resident files and found they contained the required documents. LPA interviewed three residents and three out of three residents said they were happy with the care and services they receive. LPA reviewed the Administrator and three (3) staff files and found they contained the required training, certification, and documents. LPA interviewed the Administrator and two (2) staff who were able to explain procedures, care, and personal rights of Residents. Infection Control During the visit, LPA observed the facility's infection control practices. LPA observed screening protocols for visitors, staff, and residents, and sanitizing stations in common areas and restrooms. LPA observed all required Infection Control postings throughout the facility. LPA observed all staff were wearing a face mask. LPA observed a 60-day supply of PPEs stored in the garage. Deficiency: Based on observation, LPA tested the water temperature in the bathrooms and kitchen and they measured between 120.4-degrees and 124.3-degrees Fahrenheit. Administrator changed the temperature during visit and temperature was retested and measured 115.0-degrees Fahrenheit. An exit interview was conducted with Administrator Kadiguia Linayao, and a copy of this report, and appeals rights were provided.the state’s words, verbatim · CDSS document, Sep 14, 2023

Type of visit: Required - 1 Year

On 12/10/22, Licensing Program Analyst (LPA) Ernand Dabuet conducted an unannounced annual required visit with a primary focus on Infection Control measures using the CARE Inspection Tool. LPA met with administrator Kadiguia Linayao and explained the purpose of today’s visit. The facility is licensed to operate for six (6) elderly non-ambulatory adults of which one (1) may be bedridden. The facility is approved for two (2) hospice residents. The facility is a single-story structure located in a residential neighborhood. It consists of the following: (4) resident's rooms, three (3) common bathrooms, a living area, a dining area, a kitchen, and an outside covered patio area. LPA and administrator toured the physical plant. There were no bodies of water on the premises. All rooms were inspected. Beds and bedding supplies were in good condition, adequate lighting was provided, storage for resident personal belongings was observed. Bed linens, comforters, and bath towels were adequately stocked at the time of visit. Bathrooms were found to be within Title 22 regulations and were clean and operational. The hot water temperature was tested at 112.1 F. A comfortable temperature of 71 degrees was maintained in the facility. LPA observed the facility to be appropriately furnished at the time of visit. Storage areas for personal hygiene, and sharps objects were stored and not accessible to residents. The kitchen was inspected and there is sufficient perishable and non-perishable food available maintained properly. The facility has several fire extinguishers that were charged, smoke detectors, and carbon monoxide was operable. The facility conducted a Fire/Safety Drill on 11/23/22. A working landline telephone remains available. The facility has a current liability insurance effective 05/01/22 - 05/01/23. A reviewed of Medication Administration Records (MAR) was found to be maintain in order accurate. Evaluation Report Continues on LIC 809-C INFECTION CONTROL: During the visit, LPA observed the facility's infection control practices. LPA observed screening protocols for visitors, staff, and residents, and sanitizing stations in common areas and restrooms. LPA observed staff wearing face coverings, LPA observed the facility has a 30-day supply of Personal Protective Equipment (PPE). All mandated inspection control posters were posted. A review of the resident's and staff's vaccination records was conducted. The facility has a Mitigation Plan Report on file with CCLD and an Infection Control Plan. DEFICIENCY: Based on record reviews, LPA identified staff #6 and staff #7 (S6-S7) did not have a current CPR/First Aid Certificate on file. The facility currently has (3) hospice residents and the facility is only approved for (2) hospice resident. The facility submitted a hospice waiver increase in 05/11/22. The hospice waiver is pending with CCLD. Based on interviews, observation, and record reviews the licensee violated the California Code Regulations (CCR) of Title 22, Division 6, Chapter 8, Deficiency are issued and an exit interview is conducted with Kadiguia Linayao. A copy of this report, appeal rights, and civil penalty were provided.the state’s words, verbatim · CDSS document, Dec 10, 2022

Type of visit: Case Management - Other

On 11/03/2021 Licensing Program Analyst (LPA) Don Senaha conducted a Case Management visit to follow up on an incident report. LPA was greeted by Administrator Kadiguia Linayao and explained the purpose of the visit was to get more details about the incident reports. LPA met with Administrator Kadiguia Linayao and discussed the incident reports on 10/29/2021 and 10/30/2021. LPA gathered contact information for staff. LPA interviewed staff (S1, S4) about incidents. LPA did a tour of the physical plant. There were two (2) staff and no residents present at the time of the visit. There were no deficiencies found at the time of the visit. An exit interview was conducted with Kadiguia Linayao and a hard copy was provided for signature.the state’s words, verbatim · CDSS document, Nov 3, 2021

Type of visit: Case Management - Other

On 10/30/21, at 1:30 pm, Regional Manager (RM)/Benita Yates, Licensing Program Manager (LPM)/ Eva Alvarez and Licensing Program Analyst/ Susan Campos, conducted a case management visit, per request of the Administrator/ Licensee Kadiguia Linayao, to relocate, on 10/30/21, three Adorable Redbeam Home facility residents, to other, designated licensed assisted living care facilities. RM Yates and LPM Alvarez were allowed entry into the facility by Luz Parites, caregiver, and upon entry RM Yates, and LPM Alvarez explained to Ms. Parites, the purpose of the case management visit. LPM Alvarez conducted, a health and safety check of the four bedrooms and three bathroom facility, and also inspected the food supply. In addition, Ms. Alvarez inspected the facilities' infection control plan, upon entry into the facility. At 2:10 pm, Administrator/ Licensee Kadiguia Linayao, arrived at the facility. Ms. Linayao, informed RM Yates, and LPM Alvarez that, as a result, of the facilities' staff shortage, the facility, at this time, would not be able to care for the three facility residents, and that they would be relocated, on 10/30/21, to other designated RCFE facilities. Ms. Yates informed Administrator/ Licensee Ms. Linayao, that she would need to submit, a staff schedule report plan, to DSS-CCL, prior to admission, of new residents to the Adorable Redbeam Home facility. On 10/30/21, at 1:30 pm, LPM Yates observed an inoperable para transit bus parked, in the facility's driveway, and also observed that currently, the bus interior, was being used as a storage area. On 10/30/21, at 2:10 pm, LPM Yates observed, on top of the facility's dining room table, a pair of scissors, while also observing, a resident sitting, on the same table, having lunch. In addition, Ms. Yates observed, a pill case container, in S2's unlocked walker storage. Deficiencies cited under California Code of Regulations, Title 22, Division 6, Chapter 8. Exit interview conducted and a copy of the appeal rights were given to Administrator/ Licensee Kadiauia Linayao at the time of the visit.the state’s words, verbatim · CDSS document, Oct 30, 2021

From the deficiency page — Deficiency type: Type A · Section cited: CCR 87413(a)(1) · Plan of correction due date: Oct 30, 2021

87413 Personnel - Operations(a) In each facility: (1) When regular staff members are absent, there shall be coverage by personnel with qualifications adequate to perform the assigned tasks. This requirement is not met as evidenced by: Based on interview, observation, and record review the licensee failed to ensure the safety of the residents, RM Yates was informed on 10/30/21, at 10:46am, by a text, from individual on behalf of the Administrator, that facility did not have sufficient staff, to care for three residents, and would be relocating the residents to other RCFE facilities which posed a health risk to residents in care.the state’s words, verbatim · CDSS document, Oct 30, 2021

Plan of correction: Administrator will submit to DSS Licensing-LPA Senaha a staff schedule report prior to the admission of any new residents to the Adorable Redbeam Home facility.

From the deficiency page — Deficiency type: Type A · Section cited: CCR87705(f)(1) · Plan of correction due date: Oct 30, 2021

87705 Care of Persons with Dementia...(f) The following shall be stored inaccessible to residents with dementia:(1) Knives, matches, firearms, tools and other items that could constitute a danger to the resident(s). This requirement is not met as evidenced by: Based on interview, observation, and record review the licensee failed to ensure the safety of the residents, RM Yates observed on 10/30/21, at 2:10pm, scissors on top of dining table, and also, RM Yates observed a pill box in S2 walker storage which posed a health risk to residents in care.the state’s words, verbatim · CDSS document, Oct 30, 2021

Plan of correction: Administrator was informed of the accessibility of the scissors, and pill box to residents, in care, and immediately removed the items from the dining table and storage walker and placed the items in a locked closet drawer.

From the deficiency page — Deficiency type: Type B · Section cited: CCR 87307(a) · Plan of correction due date: Nov 30, 2021

87307 Personal Accommodations and Services(a) Living accommodations and grounds shall be related to the facility's function. The facility shall be large enough to provide comfortable living accommodations and privacy for the residents, staff, and others who may reside in the facility. The following provisions shall apply: This requirement is not met as evidenced by: Based on interview, observation, and record review the licensee failed to ensure that facility ground items are safe for the residents, on 10/30/21, RM Yates observed an inoperable para transit bus parked in the facility's drive way, and also observed, that the inside of the bus was used as storage space, which posed a potential health risk to residents in care.the state’s words, verbatim · CDSS document, Oct 30, 2021

Plan of correction: Administrator will remove the para transit bus from the facility's driveway, and fax a photo copy of the facility drive way to LPA Senaha. POC due date: 11/30/2021. LPA fax number: (323) 981-1781

Type of visit: Prelicensing

On 9/9/21 Licensing Program Analyst (LPA) Martessa Brown conducted an announced visit to the facility for the purpose of a pre-licensing evaluation. During today’s visit LPA met with Liyan and conduct a tour of the facility an application was submitted to CCLD on 08/16/2021, for a Residential Care Elderly Facility to serve residents 60 and over. 6 Non-Ambulatory and 1 may be bedridden. The facility has 4 bedrooms, 3 bathrooms, kitchen, living room and dining area, attached two car garage with washer and dryer and 1 frigerated and small deep freezer which is for staff use. LPA observed outside area has a covered patio that contained 1 table, couch and 2 chairs. Outdoor passageways, walkways, driveways, steps and patios are free from obstructions. LPA did not observe hazards, such as ladders, gardening tools and/or motorized equipment in the front, back and/or side areas of the facility. Bedrooms Residents: All Bedrooms are for 6 non-ambulatory clients. Bedrooms #1-#4 each have beds, one table and chair, one lamp in addition to overhead lighting. There is one nightstand with drawers in each bedroom which comply with the requirement of 8 two drawers and permanent closet space. There were no designated staff bedrooms observed. Bathrooms: Have a working toilet, wash basins, and Bathrooms #1 has a shower/tub with 1 grab bar on the side of the wall. Bathrooms #2- #3 has a shower and tub with grab bars. LPA observed adequate lighting through he facility. Linens & Hygiene Supplies: Beds have the required linen/supplies which include, pillowcase, mattress pads, fitted sheet, blanket and bedspreads. Adequate supply of linen stored in hall closet. LPA observed closet fully stocked with mask, gowns and hand sanitizer. LIC-809 is on the next page Emergency Phone Numbers, Exit Plan & Menu: The telephone system has a land line. Emergency Disaster Plan and "See something, Say something Let Us Know" posted & readily available for review on the wall between the living room and kitchen. Menu available for review located in a locked kitchen cabinet opposite the refrigerator. Fire Extinguisher mounted on the kitchen wall opposite postings. Food Service: Dishes, cups and flat ware are stored in the kitchen cupboards, inspected and in good repair. Knives, cutlery and other sharp kitchen utensils are stored in a locked cabinet located in the kitchen area. Food supply; stored in kitchen refrigerator and cabinets and consists of the following: A variety of Fresh and Canned fruit, vegetable and meat food items. Smoke Detectors: 6 hard wired smoke detectors are battery and electric operated & working. Carbon monoxide detector located in the living room and mounted to the wall. Appliances: Stove burners, oven, microwave, washer, and dryer working. There are 2 refrigerators in the home, one in the kitchen and one in the garage for additional food storage. Refrigerator in the kitchen has a measured temperature of at least 47 degrees Fahrenheit for appropriate food storage. Freezer is at 0 zero degrees Fahrenheit. The residence is equipped with central air and heat and each client bedroom is individually climate controlled. Toxins: Locked/stored in the storage room located in the kitchen. Water Temperature: Tested in bathroom #1 107 F, #2 106 F and #3 106 F degrees. Medications, First-Aid Kit & Book: Medication administration records and first aid kit has been inspected which has at least the following: thermometer, tweezers, scissors, antiseptic, bandages, gauze and current first aid manual, which are stored in locked kitchen cabinet adjacent the refrigerator, available for staff use but inaccessible to residents. Clients & Staff Records of staff and clients shall be stored in a locked in staff office and the section has been inspected along with the available records present. Administrator will not be handling resident’s money. LIC-809-C is on the next page Reading Material, Games, Equipment & Materials: The facility has board games, books, and other recreational materials for the client's use. Pool/Jacuzzi & Pets: LPAs did not observe any pet or bodies of water at the facility. Fire clearance: Fire Clearance was approved on 6/18/21 for 6 non-ambulatory and 1 may be bedridden. LPA did not observe pad locks or other mechanisms which may be obstructions for safe and quick egress during an emergency on side. Component III was conducted on the day of the pre-license 9/9/21. Facility, information provided about how to operate the facility within substantial compliance. LPA did not observe any deficiency during the inspection.the state’s words, verbatim · CDSS document, Sep 9, 2021

Type of visit: Office

Facility Type: RCFE Application Type: CHOW Capacity: 6 Census: 4 COMP II Participant: Kadiguia Linayao, Administrator/Managing Member Interview Method: Telephone interview On 8/17/21, applicant/administrator participated in COMP II. Identification of the applicant/administrator was verified through interview questions based on photo ID and other identifying personal information. During COMP II, applicant/administrator confirmed the understanding of the California Code Title 22 Regulations. Signed LIC 809 with copy of photo ID have been obtained. During COMP II, CAB analyst confirmed Applicant/Administrator’s understanding of following areas: 1. Facility operation: License type, client/resident populations, and program 2. Admission Policies 3. Staffing requirements & Training 4. Restrictive/Prohibited Health Conditions 5. General provisions 6. Emergency Preparedness 7. Complaints & Reporting 8. Pre-licensing readinessthe state’s words, verbatim · CDSS document, Aug 17, 2021