Brookfield Home Care

Type of visit: Case Management - Deficiencies

On 10/19/23, Licensing Program Analyst (LPA) Kevin Mknelly, conducted a case management visit while delivering complaint findings and met with Administrator. On 10/10/23, LPA Mknelly delivered complaint findings to the facility. At the time of the visit, caregiver S1 was at the home and providing resident care and supervision. The Administrator was away from the facility at the time, leaving S1 as the sole caregiver. Following the visit, LPA checked for S1’s criminal background clearance and association to the facility and found that S1 had not been cleared. Communication with the administrator also found that S1 did not have required health screening nor training. As a result of this incident, the following deficiencies were cited on 809-D, per Title 22 Regulations, Division 6. (A)This poses an immediate Health and Safety risk to clients/residents in care. (B) This poses a potential Health and Safety risk, or personal rights violation, to clients/residents in care. Civil penalties are also issued. Report reviewed. Copy of report and appeal rights providedthe state’s words, verbatim · CDSS document, Oct 19, 2023

From the deficiency page — Deficiency type: Type A · Section cited: CCR 87355(e)(1) · Plan of correction due date: Oct 26, 2023

Criminal Record Clearance. (e )All individuals subject to a criminal record review …shall prior to working, residing or volunteering in a licensed facility: (1) Obtain a California clearance ...This requirement was not met based records and statements. This posed a risk to residents.the state’s words, verbatim · CDSS document, Oct 19, 2023

Plan of correction: Staff are not working until clearance is approved. Licensee will submit a backup staffing plan and new LIC 500 by the POC date of 10/26

From the deficiency page — Deficiency type: Type B · Section cited: CCR 87412(a) · Plan of correction due date: Nov 2, 2023

Personnel Records (a) The licensee shall ensure that personnel records are maintained on the licensee, administrator and each employee. This requirement was not met based on statements and records. This posed a potential riskthe state’s words, verbatim · CDSS document, Oct 19, 2023

Plan of correction: Licensee will submit a statement of understanding and intent to follow this requirement by the POC date of 11/2/23.

Allegation investigated: Staff slapped resident Staff neglecting resident

On 10/10/23, Licensing Program Analyst (LPA) Kevin Mknelly conducted an unannounced complaint investigation visit to deliver the findings for the above allegations and met with caregiver. Administrator spoke by phone and is unavailable to attend. LPA conducted records review and interviews. LPA is unable to find and or meet the preponderance, per policy. On 9/3/23 R1 was reported, by the licensee, to have had an aggressive episode toward a caregiver (S1) at approximately 10 AM due to R1 not wanting to take medications. The facility staff called hospice. Hospice nurse responded at approximately 2:30 PM and Hospice records reported that R1 was no longer agitated. On 9/4/23, some time after midnight, R1 left the facility unassisted and walked to a neighbor’s yard. R1 reported that a caregiver had hit R1 when R1 refused to take medications. Facility staff (S2) was working on the overnight of 9/4/23. S2 had reportedly used the restroom and when they returned to the common area, S2 saw the front door open and that R1 had gone outside. Unsubstantiated A police report concluded that based on the totality of statements provided the officer did not have probable cause to believe R1 was physically abused by caregivers at the home. In the allegation, it was also alleged that R1 had sustained a back injury. Interviews with family of R1 confirmed that R1 had had x-rays that found a spinal fracture but that it was of unknown origin or when it may have occurred. Before admission to this facility, R1 had had a fall at skilled nursing that resulted in injury. However, no x-ray was done at that time. R1 also had a fall on 8/24/23, at this facility, at which time he said that he thinks his back was broken. On 8/25/23 was when the back fracture was diagnosed. R1's responsible party stated that the fracture could have occurred prior to admission. Family stated that following R1's fall in Skilled Nursing, R1 has undergone rapid recline. With conflicting accounts of the 9/3/23 event by caregivers and R1 and that R1 did not continue to state that staff hit R1 in R1’s account to hospice, the department is unable to find a preponderance of evidence whether staff hit R1 or of R1 hit staff. Additionally, staff interviews, hospice records nor family statements found neglect of R1’s care needs. The issue of R1’s leave from the facility unassisted on 9/4/23, is addressed in a separate facility report. As a result of this investigation, LPA finds allegation to be (US)Unsubstantiated - A finding that the complaint is Unsubstantiated means that although the allegation may have happened or is valid, there is not a preponderance of the evidence to prove that the alleged violation occurred. Exit interview with administrator and report provided to designee Sandra Janette Garcia.the state’s words, verbatim · CDSS document, Oct 10, 2023 · control 59-AS-20230905104828

Type of visit: Case Management - Deficiencies

On 10/10/23, Licensing Program Analyst (LPA) Kevin Mknelly, conducted a case management visit while delivering complaint findings and met with caregiver . Administrator spoke by phone and is unavailable to attend. On 9/27/23, licensee provided a statement that on 9/4/23, some time after midnight, R1 left the facility unassisted and walked to a neighbor’s yard. Facility staff (S2) was working on the overnight of 9/4/23. S2 had reportedly used the restroom and when they returned to the common area, S2 saw the front door open and that R1 had gone outside. Licensee also reported that the alarm to the front door was inoperable. Also on 9/27/23, LPA observed that the door alarm had not yet been repaired. At the time of the 9/4/23 incident R1 had a prescription for medication as needed for sleep. 8/28/23- 9/2/23, facility records show that R1 was given the medication daily for sleep. However, records did not show R1 having received the medication. The facility’s plan of operations states that all exterior doors have an operational bell/buzzer or other auditory device to alert staff when the door is opened. LPA and licensee reviewed reporting requirements related to other incidents in which R1 was involved. As a result of the investigation, the following deficiencies were cited on 809-D, per Title 22 Regulations, Division 6. (A)This poses an immediate Health and Safety risk to clients/residents in care. (B) This poses a potential Health and Safety risk, or personal rights violation, to clients/residents in care. Report reviewed. Copy of report and appeal rights provided to designee.the state’s words, verbatim · CDSS document, Oct 10, 2023

From the deficiency page — Deficiency type: Type A · Section cited: HSC 1569.312(d) · Plan of correction due date: Oct 24, 2023

Basic services requirements. Every facility required to be licensed under this chapter shall provide at least the following basic services: (d) Being aware of the resident's general whereabouts, ... This requirement was not met based on statements and observation that R1 had known overnight sleeplessness and that R1 was able to leave unobserved. This posed an immediate risk to R1.the state’s words, verbatim · CDSS document, Oct 10, 2023

Plan of correction: Licensee has repaired the existing door alarms. Licensee will submit the plan to upgrade their door alarms and additional measures for overnight supervision to ccl by the POC date of 10/24/23.

Type of visit: Required - 1 Year

On 04/26/2023, Licensing Program Analyst (LPA) Ivan Avila, arrived at the facility unannounced to conduct a 1-Year Required Annual Inspection. LPA met with Facility Administrator, Ramona McGill and explained the purpose of the visit. LPA ensured she used hand sanitizer shortly after entering the facility and the following Personal Protective Equipment (PPE) was worn: surgical mask. Additionally, LPA was screened by administrator. LPA Avila and Administrator toured facility together to ensure health and safety of residents in care. Areas toured include but are not limited to: common areas, resident bedrooms, backyard, and common restrooms. LPA observed the facility to be clean, in good repair and odor-free and each bathroom to have the necessary grab bars, non-skid flooring and shower chair, paper towels, trash can with lids and 20-second hand-washing poster. Facility has a 2-day perishable and a 7-day non-perishable amount of food and sharps to be locked. Hot water temperature was measured at 108 F. LPA observed one (1) fire extinguisher, fire detectors, and carbon monoxide detectors. In the areas toured no immediate health, safety, or personal rights violations were observed. LPA Avila reviewed a total of two (2) residents' files and one (1) staff files. LPA also reviewed one (1) residents' medication and compared it to the centrally stored medication log. Several topics were discussed. 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, Apr 26, 2023

Allegation investigated: Staff was told to sleep in a bathroom at the facility. Facility is dirty.

Licensing Program Analyst (LPA) Talwinder Bains arrived at the facility unannounced on 10/03/22 to deliver findings of the complaint investigation for above allegations. LPA met with administrator Ramona McGill and explained the purpose of the visit. Prior to the visit , LPA completed required COVID-19 testing protocols and the daily self-screening questionnaire for symptoms of COVID-19 infection to affirm no COVID-19 related symptoms. LPA wore the following Personal Protective Equipment (PPE) during today's visit-surgical mask. LPA was screened by facility staff upon entry. The department conducted records review ,facility observations and interviews to investigate the complaint. **Report continued on LIC9099-C** Unfounded **report continued from 9099(A)----- Allegation- Residents are left alone without staff at night. -UNSUBSTANIATED. The department conducted interviews and records review to investigate above allegation. Department revealed from facility record review from April 2022 through September 2022 that facility have staff working night shifts. Facility residents stated during interviews that residents are not left alone at night and facility has awake night staff to provide care and supervision. Based on this information, department has concluded that this allegation is UNSUBSTANTIATED. Allegation- Staff are not assisting residents with managed incontinence. UNSUBSTANTIATED. The department conducted interviews, facility observation and record review to investigate above allegation. During interviews with facility staff and residents, it has been revealed that facility are providing care to residents according to resident’s needs and service plans. During residents’ and staff interviews, it has been concluded that facility has enough staff to meet the needs of the residents in care. During department visits, department observed that residents appeared to be well groomed and in good care, therefore, the above allegation is found to be UNSUBSTANTIATED. Based on interviews conducted by the Department, facility observations and records review, the preponderance of evidence standards has not been met. Therefore, the above allegations are found to be UNSUBSTANTIATED. A finding that a complaint allegation is unsubstantiated means that although the allegation may have happened or is valid, there is not a preponderance of the evidence to prove that the alleged violation occurred. No citations were issued today. Exit interview was conducted with Administrator and a copy of this report was provided to the facility. The signature of the Administrator on these forms acknowledges receipt of these documents. **report continued from 9099----- Allegation- Staff was told to sleep in a bathroom at the facility. UNFOUNDED. The department conducted interviews, facility observations and records review to investigate above allegation. Based on interviews with residents and facility staff, department learned that staff are not sleeping in the bathroom at the facility. During facility observations, department has observed no evidence that facility staff were sleeping at any of facility bathrooms. Based on this information, department has concluded that this allegation is UNFOUNDED. A finding that the allegations are unfounded means that the allegations are false, could not have happened, and/or is without a reasonable basis. Allegation- Facility is dirty. UNFOUNDED, The department conducted interviews and facility observations to investigate this allegation. During departmental visits, department did not observe any unsanitary practices at the time of the facility inspection. In addition, interviews with residents and staff indicated that facility staff clean the facility daily including disinfecting. The department has investigated the complaint alleging (Facility is dirty). We have found the complaint was UNFOUNDED, meaning that the allegation is false, could not have happened, and/or is without a reasonable basis. Based on information above, department concluded that all these allegations are UNFOUNDED, A finding that the allegations are unfounded means that the allegations are false, could not have happened, and/or is without a reasonable basis. No citations were issued today. Exit interview was conducted with Administrator and a copy of this report was provided to the facility. The signature of the Administrator on these forms acknowledges receipt of these documents.the state’s words, verbatim · CDSS document, Oct 3, 2022 · control 25-AS-20220429145458

Type of visit: Office

An office meeting was held today, 05/06/2022, via face-time Microsoft Teams meeting due to COVID-19 and precautionary measures. The purpose of today's meeting was to address the facility's control of property. The owner of the property gave notice that they are going to sell the property and the lease is up on June 30, 2022. The following Licensing staff were present: Troy Ordonez, Licensing Program Manager; Laura Munoz Licensing Program Manager; and Kerry Hiratsuka, Licensing Program Analyst (LPA) The following representatives were present: Ramona McGill, Licensee The following topics were covered during today's meeting: -change-of-location process if Licensee moves facility to another location -if the licensee is able to lease the property from new owner of property than a new lease agreement is required -facility closure plan if no solution if found -eviction notice requirements and to send a copy of Community Care Licensing Division (CCLD) -notification to residents and their responsible parties about events Licensee shall keep Community Care Licensing Division updated on the status. An exit interview was conducted and a copy of this report will be provided to the facility via email. A copy must be signed and returned to CCLD.the state’s words, verbatim · CDSS document, May 6, 2022

Type of visit: Required - 1 Year

Licensing Program Analysts (LPAs) Talwinder Bains and Kerry Hiratsuka arrived at the facility unannounced on 04/27/2022 to conduct a Required-1 Year Inspection utilizing the infection control domain. LPAs met with Administrator , Ramona McGill , and explained the purpose of the visit. Prior to initiating the annual inspection, LPAs completed required COVID-19 testing protocols, the daily self-screening questionnaire for symptoms of COVID-19 infection to affirm no COVID-19 related symptoms. LPAs wore the following Personal Protective Equipment (PPE) during today's visit: surgical masks. LPAs and Administrator toured facility together to ensure the health and safety of residents in care. Areas toured include but are not limited to: kitchen, common areas, five bedrooms, two bathrooms, medication closet , garage, laundry room and backyard. In the areas toured no immediate health, safety, or personal rights violations were observed. LPAs and Administrator completed the infection control domain together and there were a couple of issues that were found: This facility is not following the infection control plan that was submitted in 2021. The facility does not have a complete visitor log that shall include screening for infection symptoms, staff wearing masks, daily screening of residents and staff for infection. Also found during today's visit: garage is used as a sleeping area and a closet inside the facility is also used as a sleeping area and they do not have a fire clearance. This is a zero tolerance and results in $500.00 immediately civil penalties assessed. Licensee did remove the bed from the garage and bed in the closet during visit and stated she shall not use the areas for sleeping. The garage may be used as a break area, but cannot be used to as a permanent occupied space or as living space. Deficiencies cited under Title 22, Div 6. See LIC 809D. A $500.00 immediate civil penalty was assessed during today's visit. Failure to correct the citations shall result in civil penalties that shall accrue. Exit interview conducted and copy of report left at the facility. Appeal rights given.the state’s words, verbatim · CDSS document, Apr 27, 2022