Cedarcreek Manor

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Tuesday Cabiness arrived at the facility to conduct an annual inspection. LPA was greeted by caregiver Elsie Gomez, who allowed LPA to enter. Administrator Dr. Richard Gordon was contacted, and everyone was informed the reason of the visit. A complete inspection/tour of the facility was conducted from the inside and outside. The following was observed during the inspection: Kitchen: LPA observed Licensing requirement of (7) day nonperishable, and (2) perishable, with extra refrigerator and freezer stocked with food, in the garage. Food was properly wrapped, and appliances were functional, clean, and in good repair. Chemicals, household supplies, and knives, and medication were stored in the kitchen and garage area which was locked and secured. Living/dining: All indoor passageways were free from obstruction; inside temperature was comfortable, with adequate lighting, and all areas were clean and appropriately furnished for resident’s comfort. Bedrooms: The facility has (6) bedrooms; with (1) room for staff. All bedrooms were properly furnished and supplied with appropriate bedding and linens. There were sufficient linens observed and available. Bathrooms: There are (3); all were clean, with soap and towels, grab bars, and non-skid mats. Hot water measured at 116.6. degrees Fahrenheit. Surrounding Grounds: There were no visible hazards; passageways were free from obstruction and gates were easily accessible to open. The facility has outdoor furniture, with a covered shaded area for residents and visitors. The facility does not have a swimming pool/body of water. The garage is being used for storage and laundry. Laundry detergents, cleaning agents and other toxins are stored in a locked cabinet in the garage. All exit doors have alarms; all were operating. Fire extinguisher fully charged. First aid kit furnished fully equipped. Smoke alarms and carbon monoxide detectors were tested and operating properly. Record review: A complete record review of staff and residents were conducted. Resident # 1 (R1) was missing a current appraisal needs/service plan. LPA observed Administrator Richard Gordon signed off on (2) physician reports, dated 01/05/2023 and 06/05/2022. LPA reviewed R1's records and determined that R1 has primary physician and is a Kaiser patient. Although the Administrator is a licensed medical professional, R1 has a primary physician and medical reports should be reviewed and signed by the appropriate doctor. Further review of this matter may need to be addressed at a later date and time. Technical violations issued to address the medical records and physician report. Medication records reviewed; no issues observed during visit. Staff records were reviewed. Infection/Mitigation Control Review: Upon entry, staff checked LPA temperature and there was a sign in sheet with a cleaning station. The common areas were observed to be clean, including resident rooms, and staff and visitor bathrooms. Staff were not wearing masks upon entry but put them on during the inspection. Soap and towels, and hand washing signs were visually posted. Hand washing, coughing etiquette, physical distancing, and other necessary signs were posted in the bathroom and throughout the facility. The facility has sufficient stock of PPE. The facility has cleaning procedures and protocols in place, which include staff cleaning common areas throughout the day. The facility has documentation of all vaccination records for staff and residents. There are current staffing issues; during today's visit, LPA observed (3) staff on duty. The facility continues to implement the best practices for the facility; to ensure the health and safety of residents and staff. The facility is aware to report any changes with residents and staff to Licensing and there LPA, pertaining to positive COVID-19 cases. Exit interview and copy of report provided.the state’s words, verbatim · CDSS document, Sep 5, 2023

The state marks this report as 5 pages; the online copy we transcribed has 2. You can request the full file from the county licensing office.

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Abeye Duguma met with staff, Elsie Gomez, for a One (1) Year Required - Infection Control visit for this facility. LPA explained the reason for the visit. A tour of the physical plant was conducted at 9:30am and the following was noted: There is one entrance being utilized at the facility. Screening area is located immediately upon entrance. Sign in sheet, infrared thermometer, hand sanitizer, gloves and masks are available. LPA was screened upon entry. All staff were observed to be wearing masks upon entrance and during the visit. Signs to wear masks and other COVID 19 prevention protocol signs were posted outside the doors. Hand washing, coughing etiquette, physical distancing and other necessary signs were posted in the bathroom and throughout the facility. The facility has sufficient stock of PPE. The facility has a total of six (06) bedrooms of which five (05) are for residents and three (03) bathrooms for both residents and staff. The facility is fire cleared for six (06) bedridden. The facility is currently occupying five (05) residents of which one (01) is bedridden. The facility has outdoor furniture, with a covered shaded area for residents and visitors. The facility does not have a swimming pool/body of water. The garage is being used for storage and laundry. Laundry detergents, cleaning agents and other toxins are stored in a locked cabinet in the garage. Food Service/Kitchen area was sufficiently stocked with at least two (2) days perishable and seven (7) days non-perishable food. Frozen foods are properly wrapped and stored appropriately. Food storage and preparation areas are clean and inaccessible to pests. Knives and sharps are observed to be locked in a locked drawer inaccessible to residents. Living/common and dining room furniture were also checked. The living room is neat and clean along with the dining room. The facility maintains a comfortable temperature at 78°F. (continued on LIC 809-C) The smoke and carbon monoxide detectors are hardwired, interconnected and observed to be operational. The facility has a fire sprinkler system. Fire extinguisher is located in the kitchen, observed to be full and last inspected on 08/13/2021. No medications are observed in the staff room. The residents' rooms are adequately furnished with appropriate furniture and lighting system. Hallways/passageways are well lit. Residents have enough personal hygiene product provided by the licensee. The bathroom was checked for cleanliness and proper operations. The hot water temperature was measured at 115.2°F. Towels and washcloths are not shared. There was enough clean linen available in the hallway closet. LPA observed medication to be locked and inaccessible to residents in the storage (coat) closet. Exit interview conducted. Copy of this report issued.the state’s words, verbatim · CDSS document, Jun 7, 2022

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Abeye Duguma met with, Angelito Gomez, for a One (1) Year Required - Infection Control visit for this facility. LPA explained the reason for the visit. A tour of the physical plant was conducted at 2:00pm and the following was noted: There is one entrance being utilized at the facility, there are required posters posted at the main door. Screening area is located immediately upon entrance. Sign in sheet, infrared thermometer, hand sanitizer, gloves and masks are available. LPA was screened upon entry. All staff were observed to be wearing masks upon entrance and during the visit. Signs to wear masks and other COVID 19 prevention protocol signs were posted outside the doors. Hand washing, coughing etiquette, physical distancing and other necessary signs were posted in the bathroom and all over the facility. The facility has a designated outdoor visitors' area located in front of the building. The facility has sufficient stock of PPE in a storage cabinet located in the garage. The facility has a total of five (05) bedrooms of which four (04) are for residents and two (02) bathrooms for both residents and staff. The facility is fire cleared for six (06) bedridden and a hospice. The facility is currently occupying four (04) non-ambulatory residents and two (02) under hospice care. The facility has outdoor furniture, with a covered shaded area for residents. The facility does not have a swimming pool/body of water. The garage is being used for office, storage and laundry. Laundry detergents, cleaning agents and other toxins are stored in a locked cabinet in the garage. Food Service/Kitchen area was sufficiently stocked with at least two (2) days perishable and seven (7) days non-perishable food. Frozen foods are properly wrapped and stored appropriately. Food storage and preparation areas are clean and inaccessible to pests. (continued on LIC 809-C) Knives and sharps are observed to be locked in a locked drawer inaccessible to residents. Living/common and dining room furniture were also checked. The living/common room is neat and clean along with the dining room. The facility maintains a comfortable temperature at 72°F. The smoke and carbon monoxide detectors are hardwired, interconnected and observed to be operational. Fire extinguishers are located in the kitchen, observed to be full and last inspected on 08/13/2021. Staff rooms were observed to be locked and located near the kitchen area. No medications are observed in the staff room. The residents' rooms are adequately furnished with appropriate furniture and lighting system. Hallways/passageways are well lit. Residents have enough personal hygiene product provided by the licensee. The bathroom was checked for cleanliness and proper operations. The hot water temperature was measured at 109.2°F. Towels and washcloths are not shared. There was enough clean linen available in the coat closet. LPA observed medication and first-aid kit to be locked and inaccessible to residents in the storage closet. Exit interview conducted. Copy of this report issued.the state’s words, verbatim · CDSS document, Feb 22, 2022