Casa Elite

Type of visit: Required - 1 Year

Licensing Program Analysts (LPAs) Iby Strong and Amy Rodgers conducted an unannounced Required Annual Inspection. The facility file was reviewed prior to the visit. LPAs were welcomed by, identified themselves to, and discussed the purpose of the visit with Administrator Irma Pineda. According to the facility’s license, the facility has a maximum capacity of eight (8) clients, of whom may be non-ambulatory. LPA Rodgers, toured the interior and exterior of the facility, and inspected each room. The facility was clean, sanitary, and in good repair. Pathways were free of obstruction and slip hazards. Resident bedrooms contained the required furnishings. Doors, windows, toilets, and showers were in working order. Extra linens and hygiene supplies were present. The facility had sufficient space and equipment to facilitate dining, laundry, visitation, meetings, and resident activities. There was at least 2 days of perishable food, and at least 7 days non-perishable food present, all safely stored. Cooking/dining equipment and utensils were present. There were no toxic chemicals/poisons accessible to residents. Medications were labeled, as required, and stored in locked areas. No pools or bodies of water on the premises. Per Irma, no firearms or ammunition are kept at the facility. Carbon monoxide detectors, emergency lighting, and facility telephone were all working. Fire extinguisher(s) were present. First aid kit(s) were complete and readily accessible. Required licensing postings were observed in visible areas of the facility. LPA interviewed staff and reviewed staff record. LPA interview did not raise any licensing concerns. The files reviewed did not contain first aid training for two current staff. Confidential records were stored in locked areas. A deficiency is cited per California Code of Regulations, Title 22 (refer to the attached LIC 9099-D). An exit interview was conducted with Administrator, to whom a copy of this report, LIC 9099-C, LIC 9099-D, and the Licensee/Appeal Rights (LIC 9058 03/22) were provided to.the state’s words, verbatim · CDSS document, Nov 6, 2023

Type of visit: Case Management - Other

Licensing Program Analyst (LPA), Sabel Martinez, conducted an unannounced Case management visit. The LPA identified himself, and explained the purpose of the visit to Caregiver Veronica Naranjo. During today's visit, the LPA secured report signatures and delivered an amended report. An exit interview was conducted with Naranjo, to whom a copy of this report and the licensee appeal rights (LIC9058) were provided.the state’s words, verbatim · CDSS document, Oct 26, 2023

Type of visit: Case Management - Deficiencies

Licensing Program Analyst (LPA) Sabel Martinez conducted an unannounced Case Management visit to cite deficiencies discovered during a complaint investigation. The LPA introduced himself and disclosed the purpose of the visit to Caregiver Veronica Naranjo. Interviews, along with observations by the LPA, revealed the facility had used cannabis oil, and dried cannabis leaves to make teas for residents in care. The Cannabis oil was stored in the kitchen area in an unlocked location. Additionally, the Cannabis oil did not have the required labels. Prescribed Cannabis Gummies were also witnessed to be stored in the kitchen area in an unlocked location. These deficiencies were cited in an LIC 809D, and a Plan of Correction was jointly formulated with Administrator Pineda, over a telephone call. An exit interview was conducted with Naranjo, to whom a copy of this report, LIC 809D, and Licensee/Appeal Rights (LIC 9058), were providedthe state’s words, verbatim · CDSS document, Oct 26, 2023

From the deficiency page — Deficiency type: Type B · Section cited: CCR 87465(h)(2) · Plan of correction due date: Oct 26, 2023

87465 Incidental Medical and Dental Care (h) The following requirements shall apply to medications which are centrally stored: (2) Centrally stored medicines shall be kept in a safe and locked place that is not accessible to persons other than employees responsible for the supervision of the centrally stored medication. This requirement was not mer as evidenced by: Based on interviews and observation, the Licensee did not ensure centrally stored medication was locked in a place no accesible to residents in care, which posed a potential health, safety, and personal rights risk to 6 of 6 residents in care.the state’s words, verbatim · CDSS document, Oct 26, 2023

Plan of correction: Administrator agreed to provide centrally store medication training to all staff and submit proof of training, by 11/17/23.

From the deficiency page — Deficiency type: Type B · Section cited: CCR87475(h)(4) · Plan of correction due date: Oct 26, 2023

87465 Incidental Medical and Dental Care (h) The following requirements shall apply to medications which are centrally stored: (4) All centrally stored medications shall be labeled and maintained in compliance with state and federal laws. No persons other than the dispensing pharmacist shall alter a prescription label. This requirement was not met as evidenced by: Based on interviews and observations, the Licensee did not ensure centrally stored medication was labeled and maintained in complaince, which posed a potential health, safety, and personal rights risk to 6 of 6 residents in care.the state’s words, verbatim · CDSS document, Oct 26, 2023

Plan of correction: Administrator agreed to provide centrally store medication training to all staff and submit proof of training, by 11/17/23.

Allegation investigated: Staff administered unprescribed marijuana to residents

This is an amended report to a report signed on 9/7/2023. Licensing Program Analyst (LPA), Sabel Martinez, conducted an unannounced complaint investigation visit to deliver findings. The LPA introduced himself and disclosed the purpose of the visit to Administrator, Irma Pineda. Throughout the investigation, the Department secured pertinent records and conducted interviews with staff, residents and external sources. It was alleged staff administered unprescribed marijuana to residents in care. It was reported to the Department facility staff had provided residents with Marijuana tea and cannabis oil. Review of records collected at the facility revealed several residents had written physician orders for cannabis. The orders consisted of cannabinoid oil and cannabis infused gummies. Interviews with internal and external sources revealed the facility staff had used dried cannabis leaves to make and provide residents with Marijuana tea. Cannabis oil had also been provided to the residents by staff. (See LIC 9099-C for continuation of report.) Substantiated The cannabis oil was stored in glass jars, not labeled with instructions, dosage, quantity, nor resident information. During a visit to the facility, the LPA observed a glass jar containing dried cannabis leaves. The jar containing the dried cannabis leaves was not labeled with instructions, dosage, quantity, nor resident identifying information. The administrator confirmed staff had used the dried cannabis leaves to make tea for residents in the past. Based on the evidence gathered throughout the investigation, there was not a preponderance of evidence, therefore, the allegation was unsubstantiated. An exit interview was conducted with Pineda, to whom a copy of this report, and Licensee/Appeals Rights (LIC 9058), were provided. It was alleged staff did to treat residents with dignity. It was reported to the Department staff had retaliated against residents when residents did not do as staff asked. Interviews with internal and external sources did not reveal any concerns regarding staff not treating resident with dignity. It was alleged staff did not provide activities for residents. Interviews with internal and external sources reported witnessing staff encouraging residents to participate in activities. These activities included walking, exercising, and bingo, among others. Based on the evidence gathered throughout the investigation, there was not a preponderance of evidence to prove the alleged violations occurred, therefore, the allegations were Unsubstantiated. An exit interview was conducted with Pineda, to whom a copy of this report, and Licensee/Appeals Rights (LIC 9058) were providedthe state’s words, verbatim · CDSS document, Sep 7, 2023 · control 08-AS-20230525143229

From the deficiency page — Deficiency type: Type A · Section cited: CCR 87465(a)(5)(A) · Plan of correction due date: Sep 7, 2023

87465 Incidental Medical and Dental Care(a) A plan for incidental medical and dental care shall be developed by each facility. The plan shall encourage routine medical and dental care and provide for assistance in obtaining such care, by compliance with the following: (5) Facility staff, except those authorized by law, shall not administer injections, but staff designated by the licensee may assist persons with self-administration as needed. Assistance with self-administered medications shall be limited to the following: (A) Medications usually prescribed for self-administration which have been authorized by the person's physician. This requirement was not met as evidenced by: Based on interviews and observations, the Licensee did not ensure staff only assisted residents with medication prescribed by a resident's physician, which posed an immediate health, safety and personal rights risk to 3 of 6 residents in care.the state’s words, verbatim · CDSS document, Sep 7, 2023

Plan of correction: Administrator agreed to provide in service training to all staff regarding asisstance with self administered medication. Administrator will provide a training date to the LPA by 9/8/23. Once training is complete, administrator will send the LPA proof. Administrator will work with physicians to obtain orders for all different uses of prescribed cannabis.

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Liliana Silveira conducted an unannounced annual required licensing inspection. LPA was granted entry by Administrator Irma Pineda. LPA was granted entry after identifying themselves and disclosing the purpose of their visit. An overall tour of the facility was conducted inside and out. The inspection included, but was not limited to, verifying compliance with statutes, regulations and other written requirements that are most relevant to protecting the health of residents in care and staff, including in the area of infection control practices. LPA reviewed the facility’s Plan for Epidemic Outbreak Specific to COVID-19 Mitigation Plan Report (LIC 808) with Irma including the following sections: Person in Care, Staff, Visitors, Facilities without COVID-19, Residents, Facility has Plans for Infection Control and Physical Distancing. LPA assessed the strategies that the facility is employing for the prevention, containment and mitigation of COVID-19, implementation of infection control guidance, staff retention and essential health and safety. LPA observed one central entry point for universal entry screening; routine symptom screening initiated at entry for staff, residents and visitors; a sign-in policy enacted for all visitors; signs posted at facility entrance with the facility’s visitor policy and signs throughout the facility to promote hand hygiene, cough/sneeze etiquette and physical distancing; face coverings worn by staff; hand sanitizer/hand washing stations readily available; a designated visitation area; emergency agencies’ contact information posted in a location visible to staff and residents; and an adequate supply of PPE. The facility is in compliance with and has implemented infection control practices as outlined in its LIC 808. No deficiencies were observed during today's visit. An exit interview was conducted with Irma and a copy of this report along with the Licensee Rights (LIC 9058 FAS 01/16) was provided to Irma at the facility.the state’s words, verbatim · CDSS document, Oct 4, 2022

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Liliana Silveira conducted an unannounced annual required licensing inspection. LPA was granted entry by Administrator Irma Pineda. LPA was granted entry after identifying themselves and disclosing the purpose of their visit. An overall tour of the facility was conducted inside and out. The inspection included, but was not limited to, verifying compliance with statutes, regulations and other written requirements that are most relevant to protecting the health of residents in care and staff, including in the area of infection control practices. LPA reviewed the facility’s Plan for Epidemic Outbreak Specific to COVID-19 Mitigation Plan Report (LIC 808) with Irma including the following sections: Person in Care, Staff, Visitors, Facilities without COVID-19, Residents, Facility has Plans for Infection Control and Physical Distancing. LPA assessed the strategies that the facility is employing for the prevention, containment and mitigation of COVID-19, implementation of infection control guidance, staff retention and essential health and safety. LPA observed one central entry point for universal entry screening; routine symptom screening initiated at entry for staff, residents and visitors; a sign-in policy enacted for all visitors; signs posted at facility entrance with the facility’s visitor policy and signs throughout the facility to promote hand hygiene, cough/sneeze etiquette and physical distancing; face coverings worn by staff and residents; hand sanitizer/hand washing stations readily available; a designated visitation area; emergency agencies’ contact information posted in a location visible to staff and residents; and an adequate supply of PPE. The facility is in compliance with and has implemented infection control practices as outlined in its LIC 808. No deficiencies were observed during today's visit. An exit interview was conducted with Administrator Irma Pineda and a copy of this report along with the Licensee Rights (LIC 9058 FAS 01/16) was provided to Irma via email; an email read receipt confirms receipt of these rights.the state’s words, verbatim · CDSS document, Jan 6, 2022