Cliff View Terrace

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Kristin Kontilis conducted an unannounced Annual Infection Control Inspection visit at the above-named facility. LPA arrived at 2:00 pm and was greeted by Ruby Rodriguez, Assistant Administrator and explained the purpose of the visit. At the time of arrival, there were four (4) staff on duty and thirty-six (36) residents in care. Administrator Evelina Murphy was present during the inspection. Entrance interview conducted. The facility is a one-story Residential Care Facility for the Elderly (RCFE) with a hospice waiver for 10. Currently, there are 25 residents with a dementia diagnosis, 3 residents on hospice, and no bedridden residents. A tour of the physical environment and accommodations were assessed, and the following was noted: LPA observed the required posting of the complaint poster, bill of rights and Resident’s Rights. LPA inspected the one-story facility for fire safety, personal accommodations, and food service. The physical environment was checked for cleanliness and condition. Walls, windows, ceilings, doors, floors and floor coverings were checked. The facility was seen to be in good repair inside and outside. There are nine (9) fire extinguishers and one pull alarm. The fire extinguishers were recently inspected on 8/1/2022. The dual carbon monoxide detector/smoke alarms are in good working order. The kitchen is equipped with an automatic sprinkler system. The kitchen area was sufficiently stocked with two-day perishables and seven days of non-perishables. Snacks and beverages are readily available for Residents. Frozen foods are properly wrapped and stored appropriately. LPA observed the kitchen cabinets, refrigerator, stove, and counters are clean. Medications, First Aid kit, and additional first aid supplies are kept in a locked centrally stored cabinet. First aid kit was observed to be complete. Residents participate independently in music entertainment, joyous movement (music and chair exercise), floral arranging, books by Braille, pet therapy with various types of pets, arts and crafts, and outings to parks, restaurants, and other local attractions. Please continue to 809-C, Pg 2. Upon entrance into the facility, there are walkways, sitting areas, and a variety of plants. There are no bodies of water. The facility consists of a lobby, Administrator’s office, a cinema, the common area including the dining area, beauty salon, library, and two conference rooms. The kitchen is equipped with industrial kitchen equipment, is neat and clean. The facility maintains a comfortable temperature. There are 39 rooms with 7 private bedrooms and 32 shared rooms. There are approximately 20 bedrooms with private baths. Each bedroom has a bed, night-stands, and ceiling lights and night stand lamps to provide sufficient lighting. The bathrooms have secure grab bars and no skid flooring. All persons associated with the facility have criminal record clearance. Administrator certificate is valid. If any suspected or confirmed cases of COVID-19 are found in the facility a staff will be assigned to only work with those quarantined/isolated individuals and will not work with other COVID negative individuals until cleared by Health Department. Staff will use full PPE with N95 masks and face shields when dealing with any pending or confirmed cases of COVID-19. Precautionary Droplet signs will be posted on any room with quarantine or isolated individuals. PPE supplies will be located immediately outside those rooms when required. Facility has a 30-day supply of PPE on hand. Facility has plans for delivering medications and meals to any quarantined/isolation resident room. The facility has proper cleaning and disinfectant sprays. Facility Administrator has a plan in place for when and whom to notify in an outbreak or other emergencies. Administrator will keep a line list of all vaccinated and tested staff/residents in care with dates/results. Facility has conducted training on infection prevention, symptoms, transmission and PPE use. Facility has non-punitive sick leave polices for staff. Staff who have a respiratory illness are requested to stay home and not report to work. Activities have been modified to individuals or small groups with social distancing. Residents' medication is delivered in 30-day supplies to the facility. The facility ensures proper cleaning is done on frequently touched surfaces and between any individuals sharing of space or items. Sinks were well stocked with soap, paper towels and hand washing signs. Staff and resident records are kept in the locked staff office. Facility observes guidance changes and the most up-to-date guidance from CCL-PINS, CDC, CDPH, and local health departments should be followed to remain in compliance. The most stringent orders should be followed by any of these agencies. Exit interview conducted. No citations issued. A copy of this report has been issued..the state’s words, verbatim · CDSS document, Feb 14, 2023

Allegation investigated: Facility does not maintain a comfortable room temperature. Facility did not ensure that resident was adequately hydrated. Facility does not have activities for residents. Facility does not have adequately trained staff.

Licensing Program Analyst (LPA) Kristin Kontilis conducted an unannounced initial 10-day investigation to the allegations stated above. LPA met with Ruby Rodriguez, Assistant Administrator and Evelina Murphy, Administrator and explained the purpose of the visit. Entrance interview conducted: At the time of arrival, there were four (4) caregivers, one (1) housekeeper/caregiver, two (2) kitchen staff, and one (1) assistant administrator on duty and 28 residents in care. Administrator Evelina Murphy arrived at approximately 12:01 pm. Interviews were conducted with residents, staff, and Assistant Administrator from 11:20 am through 2:20 pm. At approximately 1:01 pm, an interview was conducted with Credible Witness One (W1). On the allegation that the facility does not maintain a comfortable room temperature, interviews conducted revealed that nine out of nine residents stated their rooms are usually comfortable and if not, residents are Please continue to 9099-C, Pg 2. Unsubstantiated promptly provided fans upon request. Four out of four staff interviewed stated fans are provided to residents upon request and staff assist residents with turning the fan on/off and positioning the fan to the residents’ comfort. LPA observed four fans in residents’ rooms. LPA interviewed Credible Witness 1 (W1) who stated the rooms are adequately furnished with fans when needed and believes that the staff are mindful about providing the fans to the rooms if/when needed. Additionally, LPA observed that the facility is at a comfortable room temperature at the time of the visit. Based on observation and interviews conducted, the allegation that the facility did not maintain a comfortable room temperature for residents in care is Unsubstantiated at this time. On the allegation that facility staff did not ensure a resident was adequately hydrated, LPA conducted interviews with residents, staff and CW1, LPA observed bottled water and water pitchers w/water and ice in the residents’ rooms. Interviews conducted revealed nine of the nine residents stated they are provided water by the caregivers. Interviews conducted with staff members revealed that caregivers frequently check on residents and make sure residents have plenty of water for hydration. Staff 2 (S2) stated bottles of water are put in the residents’ rooms as part of the caregivers’ daily responsibilities. The allegation that facility staff did not ensure a resident was adequately hydrated is Unsubstantiated at this time. On the allegation that facility does not have activities for residents, at the time of the visit, LPA observed three (3) residents playing Bingo from 1:00 pm – 2:00 pm. S2 stated at the time of observation, two residents were temporarily away from the activity. From 2:00 pm – 3:30 pm, LPA observed a musician playing and singing various contemporary and popular songs with six residents present. Assistant Administrator Rodriguez stated the musician playing at the time of the visit usually plays five days/week, plays songs upon request, and will extend the music time upon residents’ request. Additionally, a pianist visits the facility two days/week and entertains the resident’s using the facility’s grand piano. The pianist plays songs upon request, and will extend the entertainment upon residents’ request. Interviews conducted revealed that seven (7) out of nine (9) residents stated they participate in activities. Two (2) residents stated they prefer not to participate in activities; one (1) of the two stated they prefer to stay in their room most of the time. Therefore the allegation that facility does not provide activities to residents in care is Unsubstantiated at this time. On the allegation that the facility does not have adequately trained staff, Assistant Administrator stated training records are kept on file and Administrator and Assistant Administrator keep up-to-date on staff trainings and are kept in the employee’s personnel file. LPA reviewed training documents and found all trainings are current. Residents’ interviews revealed staff are attentive and provide care promptly upon Please continue to 9099-C, Pg 3. request. Moreover, records reviewed and interviews conducted revealed care staff, housekeeping staff, and kitchen staff have been employed at the facility for many years. Example, two care staff members have been employed for 6-8 years, and six care staff have been employed for 25 – 41 years. The allegation that the facility does not have adequately trained staff is Unsubstantiated at this time. Exit interview conducted. No deficiencies noted. Copy of report issued via email.the state’s words, verbatim · CDSS document, Aug 24, 2022 · control 29-AS-20220822093258

Allegation investigated: Facility did not have sufficient staffing Staff are not properly qualified to assist with medications

Licensing Program Analyst (LPA) Toan Luong conducted an unannounced complaint visit to deliver findings to the facility. LPA met with Assistant Administrator (AA) Ruby Rodriguez and explained the purpose of the visit. Allegation #1: Facility did not have sufficient staffing LPA conducted interviews with staff and residents on 11/08/2021. Interviews reveals that there are at least 6 daytime caregivers in the morning and afternoon shift with 3 in the overnight shift. Interviews among residents reveals residents are capable of communicating if needs are not being met. The faciltiy provides meals, medication, and answers call button timely. Residents also stated that the facility is meeting the residents' needs and services. Although the allegation may be valid, there is not a preponderance of evidence to prove the alleged violation did or did not occur based on interviews conducted, therefore the allegation is unsubstantiated. (Continued on 9099-C) Unsubstantiated Allegation #2: Staff are not properly qualified to assist with medications It was alleged that Mission Terrace and Cliff View Terrace did not have licensed certified nursing assistant (CNA) to assist with self-administration of medication to residents. Although Cliff View Terrace is not required to a CNA to assist with medication, LPA reviewed training logs on 11/08/2021 and determined all caregivers received 40 hours of training including 16 hours of hands-on training in January 2020. Records reveal that staff meet the requirements to assist residents with self-administration of medication. Although the allegation may be valid, there is not a preponderance of evidence to prove the alleged violation did or did not occur based on record review conducted, therefore the allegation is unsubstantiated. Exit interview conducted and report emailed.the state’s words, verbatim · CDSS document, Apr 4, 2022 · control 29-AS-20211105095252

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Toan Luong conducted an unannounced Annual One Year Infection Control visit. LPA met with Assistant Administrator (AA) Ruby Rodriguez and explained the purpose of the visit. LPA toured the facility. At 11:00 a.m., LPA discussed items in the Infection Control Module with AA and noted that all items were answered yes or n/a in the infection control module. It should be noted that the facility relays information from the California Department of Social Services Provider Information Notices (CDSS PINs) to staff, residents, and residents' responsible party verbally or a paper copy is provided upon request. LPA observed Covid hygiene signs posted throughout the facility. Personal bathrooms and shared bathroom between 2 residents did not have hand washing signs, but bathrooms leading from the facility hallways had signs posted inside the bathroom. Signs were posted prior to LPA's departure. LPA conducted exit interview and emailed report and appeal rights to the facility.the state’s words, verbatim · CDSS document, Apr 4, 2022