Corona RCFE

Type of visit: Office

Licensing Program Analyst (LPA) Mary Rico, Licensing Program Analyst Manger (LPM) Efren Malagon and San Bernardino Regional Manager Leslie Mendiveles conducted a meeting with Administrator Courtney Barreto via Microsoft Office. The additional attendees were Dovy Raskin and Fernando Rodriguez. During today’s meeting, the following matter was discussed: · Compliance with the Fire Marshall · Property Lease Agreement · Bedridden Residents · Beecan Management Agreement During today’ meeting, Administrator agreed to send Community Care Licensing ; Beecan Management Agreement with Corona RCFE LLC, Documentation of removing Vista Cove from License, written update regarding Property Lease Agreement, Copy of Contract with Troy Alarm. LPA Rico emailed a copy of the report for signature and requested the signed copy to be emailed back. The Administrator agreed to provide a signature and mail back to Community Care Licensing.the state’s words, verbatim · CDSS document, Oct 13, 2023

Type of visit: POC

Licensing Program Analyst (LPA) Mary Rico conducted an unannounced case management visit regarding the facility fire clearance status and providing care for one (1) bedridden resident. LPA Rico met with Administrator Courtney Barreto and explained the reason for today's visit. During today’s visit, LPA discovered the facility has not relocated the one (1) bedridden resident. LPA toured R1 bedroom and confirmed that R1 residences at the facility. Resident received their 30day notice on 8/2/2023. During interview with Administrator, Administrator stated facility does not have their fire clearance from Corona Fire Department. Administrator informed LPA the facility has an office meeting on 9/20/2023 with HCAI. Based on today's observation, two (2) civil penalties in the amount of $5,600 and $4,800 dollars will be issued for failure to correct the two (2) violations within a specified length of time that result in a civil penalty. The facility will be issued two (2) civil penalties per Title 22, Division 6, of the California Code of Regulations, An exit interview was conducted, and this report (LIC809) was discussed and provided to Administrator Courtney Barreto along with a copy of the two(2) LIC421IM and along with the appeal rights.the state’s words, verbatim · CDSS document, Sep 14, 2023

Type of visit: Case Management - Other

Licensing Program Analyst (LPA) Mary Rico made an unannounced visit to conduct a Case Management visit regarding facility fire clearance. LPA Rico met with Administrator Courtney Barreto and explained the reason of today's visit. During a prior visit on 8/22/2023, LPA observed one (1) bedridden resident. Administrator stated R1 received an updated physician report on 8/15/2023 indicating resident is non-ambulatory and no longer bedridden. LPA requested physician notes on why resident was transition from bedridden to non-ambulatory. During today’s visit, Administrator informed LPA that R1 had received a revised physician report on 8/24/2023 indicating R1 is back to being bedridden. Administrator stated R1 will be relocated. LPA received copies of R1 physican report. During the facility tour, Administrator stated the seal doors are on pause because facility no longer has a maintenance employee. On the first week of September 2023, facility will be receiving a substitute to assist with their maintenance. Administrator informed LPA the facility should receive their city approvals the first week of September 2023 to begin their fire alarm. Based on the observations made during today’s visit, no deficiencies were cited per Title 22, Division 6, of the California Code of Regulations. An exit interview was conducted, and this report was discussed and provided to Administrator Courtney Barreto.the state’s words, verbatim · CDSS document, Aug 31, 2023

Type of visit: Case Management - Other

Licensing Program Analyst (LPA) Mary Rico made an unannounced visit to conduct a Case Management visit regarding facility fire clearance. LPA Rico met with Administrator Courtney Barreto and explained the reason for the visit. During a prior visit on 7/28/2023 LPA discovered the facility did not relocated the three (3) bedridden residents. During today’s visit, LPA observed one (1) bedridden resident. Administrator stated that resident received an updated physician report on 8/15/2023 indicating resident is non-ambulatory and no longer bedridden. Administrator informed LPA facility is waiting for physician notes on why resident was transition from bedridden to non-ambulatory. Additional information will be provided to LPA. During the facility tour, LPA Rico observed the following items: three feet clearance from electrical panel, toxins located in their own storage inaccessible to clients in care, no open ceilings, stove removed from room 14, removed gas appliances, and no heating supplies. LPA reviewed facility fire watch log, facility began their fire watch on 7/14/2023 and have continue to document. Administrator informed LPA the facility is working on repairing the seal doors, and for their fire alarm system the facility received a quotation from “Troy Alarm, INC ” on 7/5/2023 but have not begun their installation. Administrator stated they are waiting for the city approval. At this time, Administrator did not provide a start date. LPA received copies of resident physician report, and quotation of fire alarm. Based on the observations made during today’s visit, no deficiencies were cited per Title 22, Division 6, of the California Code of Regulations. An exit interview was conducted, and this report was discussed and provided to Administrator Courtney Barretothe state’s words, verbatim · CDSS document, Aug 22, 2023

Type of visit: POC

Licensing Program Analyst (LPA) Mary Rico arrived at the facility to conduct an unannounced case management visit. LPA met with Administrator Courtney Barreto a explained the reason for the visit. LPA was accompanied by Facility Administrator Courtney Barreto to conduct a facility tour. During a prior visit on 7/20/2023, LPA Rico discovered the facility is providing care for four (4) bedridden residents which is not approved per the facilities license. During this visit, the facility was given a deficiency and a plan of correction to relocate four (4) bedridden residents. During today’s visit, LPA discovered the facility has not relocated the three (3) bedridden residents. By continuing to provide care for the three (3) bedridden residents it poses an immediate health, safety, or personal rights risk to persons in care. Based on observations today, a civil penalty in the amount of $800 dollars will be issued for failure to correct the violation within a specified length of time that result in a civil penalty. The facility will be issued one (1) civil penalty per Title 22, Division 6, of the California Code of Regulations, An exit interview was conducted, and this report (LIC809) was discussed and provided to, Administrator Courtney Barreto along with a copy of LIC42FC, and the appeal rights.the state’s words, verbatim · CDSS document, Jul 28, 2023

Type of visit: Case Management - Deficiencies

Licensing Program Analysts (LPAs) Mary Rico and Ryan Gardner and Licensing Program Managers(LPMs) Karen Clemons and Nedra Brown conducted an unannounced case management visit regarding the facilities fire clearance status with Corona Fire Department. During today visit, LPA Rico and LPA Gardner toured the facility with Corona Fire Department. The following items were not in compliances: fire rated doors were promptly open; doors should be remained closed. Doors do not have a seal label. No three feet clearance from all electrical panel, toxins were stored in the electrical panel. No gas appliances, no deadbolts, open ceilings, bedroom doors do not lash on themselves, fire alarm not dated, riser room locked, smoke detectors in room 19 not plugged, and heating devices, such as a stove in room 14. A full detailed report will be sent by the Corona Fire Department. The licensee has agreed to hire a 24hour fire watch employee to work closely with the Corona Fire Department to ensure the safety of the residents in care. The staff will be present until the facility is in compliance with Corona Fire Department. The licensee has agreed to send a daily fire watch log to LPA. The licensee has agreed to send state licensing an updated LIC200, Application For A Community Facility Or Residential, and a corporate/facility organizational chart. During facility tour, LPAs discovered the facility is providing care for four (4) bedridden resident which is not approved per the facilities license. In addition, the Administrator was not present at the facility when LPAs arrived. LPAs asked staff for documentation and were informed to wait until the Administrator returned. The facility should have a designated substitute to assist state licensing during visits. The licensee was informed that they may be called in for an informal meeting at the State Licensing Regional Office. Based on observations today, a civil penalty in the amount of $1000.00 dollars will be issued for violation of the facilities fire clearance. The facility will be issued two (2) type A deficiencies and one (1) type B deficiency per Title 22, Division 6, of the California Code of Regulations. An exit interview was conducted, and this report (LIC809) was discussed and provided to Administrator Courtney Barreto, along with a copy of LIC809D, LIC421IM, and the appeal rights.the state’s words, verbatim · CDSS document, Jul 20, 2023

From the deficiency page — Deficiency type: Type A · Section cited: CCR 87202(a)(2) · Plan of correction due date: Jul 21, 2023

87202. Fire Clearance(a)All facilities shall maintain a fire clearance approved by the city, county, or city and county fire department, or district providing fire protection services, or the State Fire Marshal. Prior to accepting or retaining any of the following types of persons, the applicant or licensee shall notify the licensing agency and obtain an appropriate fire clearance approved by the city, county, or city and county fire department, or district providing fire protection services, or the State Fire Marshal.(2)Bedridden persons. Based on observation, interview and document review, the licensee did not comply with the section cited above evidenced by providing care to four (4) bedridden resident which poses an immediate health, safety, or personal rights risk to persons in care.the state’s words, verbatim · CDSS document, Jul 20, 2023

Plan of correction: The licensee has agreed to read regulation 87202 entirely and send LPA a self-certified letter that the regulation was read and understood. The licensee has agreed to find new placement for the four (4) bedridden resident. The licensee has agreed to send LPA a plan of new placement by POC due date 7/21/2023. The licensee has agreed to send LPA proof once the four (4) bedridden resident moves out of the facility.

From the deficiency page — Deficiency type: Type A · Section cited: CCR87202(a) · Plan of correction due date: Jul 21, 2023

87202. Fire Clearance(a)All facilities shall maintain a fire clearance approved by the city, county, or city and county fire department, or district providing fire protection services, or the State Fire Marshal. Prior to accepting or retaining any of the following types of persons, the applicant or licensee shall notify the licensing agency and obtain an appropriate fire clearance approved by the city, county, or city and county fire department, or district providing fire protection services, or the State Fire Marshal. Based on observation, interview and document review, the licensee did not comply with the section cited above evidenced by operating the facility without an approved fire clearance which poses an immediate health, safety, or personal rights risk to persons in care.the state’s words, verbatim · CDSS document, Jul 20, 2023

Plan of correction: The licensee has agreed to read regulation 87202 entirely and send LPA a self-certified letter that the regulation was read and understood. The licensee has agreed to send State Licensing their plans to correct fire violations. Including any state contactors statements detailing when the corrections will be completed. POC due date 7/21/2023.

From the deficiency page — Deficiency type: Type B · Section cited: CCR 87405(a) · Plan of correction due date: Jul 24, 2023

87405.Administrator - Qualifications and Duties (a) All facilities shall have a qualified and currently certified administrator. The licensee and the administrator may be one and the same person. The administrator shall have sufficient freedom from other responsibilities and shall be on the premises a sufficient number of hours to permit adequate attention to the management and administration of the facility as specified in this section. When the administrator is not in the facility, there shall be coverage by a designated substitute who shall have qualifications adequate to be responsible and accountable for management and administration of the facility as specified in this section. The Department may require that the administrator devote additional hours in the facility to fulfill his/her responsibilities when the need for such additional hours is substantiated by written documentation. Based on observation, interview and document review, the licensee did not comply with the section cited above evidenced by not having a designated administrator substitute in the facility when administrator is not present.the state’s words, verbatim · CDSS document, Jul 20, 2023

Plan of correction: The licensee has agreed to read regulation 87405 entirely and send LPA a self-certified letter that the regulation was read and understood. The licensee has agreed to designate an administrator substitute in the facility when administrator is not present. Licensee has agreed to send LPA an updated LIC500 indicated who the will be designated administrator substitute. POC due date 7/24/2023.

Allegation investigated: Facility has mold. Facility storing expired food. Facility has insects. Facility kitchen and/or dining area is inaccessible to resident's.

Licensing Program Analyst (LPA) Rayshaun Nickolas visited the facility unannounced to deliver the finding on the above allegations. LPA met with Administrator Courtney Barreto and explained the purpose of the visit. These allegations were investigated by department staff, and during today’s visit, LPA Nickolas conducted additional interviews with relevant parties and a facility tour. Allegation #1 “Facility has mold”. The allegation alleged that the facility’s kitchen has mold. Department staff showed the Administrator a picture taken by a representative of an outside agency during the interview, and the Administrator agreed that mold had developed in the cupboards due to a leak. The Administrator stated that actions were taken to resolve the issue. Department staff interviews with residents in care revealed that no clients witnessed or admitted to observing mold in the facility. LPA Nickolas’ interview with the Administrator revealed a bad leak in the kitchen. The Administrator stated that they observed something near the bottom of the cabinet. However, the Administrator was unsure if it was mold because it was never tested. Unsubstantiated LPA Nickolas' interviews with facility staff members revealed observing mold due to a leak in the kitchen; however, the cabinets were removed, and the issue was resolved. During today's visit, LPA Nickolas' observed no mold in the facility's kitchenette. The finding is Unsubstantiated. There is no evidence or witnesses to corroborate the allegation. Allegation #2 “Facility storing expired food”. The allegation alleged bad food on the shelves, refrigerator, and freezer. Department staff interview with the Administrator revealed that all food is prepared in the other building (the Skilled Nursing Facility), also located on the premises. The department staff facility tour revealed no expired food in the facility’s kitchen. LPA Nickolas’ interview with the Administrator revealed that the Administrator denied the facility is storing expired food. LPA Nickolas' interviews with facility staff members revealed that they denied observing expired food stored at the facility. During today’s visit, LPA Nickolas' observed no expired food stored in the central kitchen in the Skilled Nursing Facility next door. LPA Nickolas' also observed no expired food stored in the kitchenette located in the facility. The finding is Unsubstantiated. There is no evidence or witnesses to corroborate the allegation. Allegation #3 “Facility has insects”. Department staff interview with the Administrator revealed that the facility had an ongoing issue of mosquitos secondary to the pipe that burst in the dining area. The Administrator stated that the facility had contracted Orkin pests’ services to eliminate the insects. Department staff noted mosquitos in most of the rooms during their initial visit. Department staff interview with resident # 1 (R1) revealed that the facility had a problem with mosquitos. Department staff interview with resident # 3 (R3) revealed that the facility had many mosquitos. Department staff interview with resident #4 (R4) revealed that there might be a bug or two (2) but not a bug problem. Department staff interview with resident #5 (R5) revealed a problem with mosquitos due to the pipe that had burst in the dining area; however, the facility is working on fixing the problem. Department staff interview with resident #6 (R6) revealed too many insects. R6 also stated that it was probably due to the pipe that had burst in the dining area. LPA Nickolas’ interview with the Administrator revealed that the facility has a contract with Orkin, which services the building once or twice a month. During today’s visit, LPA Nickolas observed two (2) Orkin electric bug zappers in the facility hall, which the administrator confirmed that the Orkin technician had installed. LPA Nickolas’ also observed two (2) mosquitos in the facility's lobby; however, the mosquitos flew inside the facility when individuals entered or exited the facility. The finding is Unsubstantiated. There is no evidence or witnesses to corroborate the allegation. Allegation #4 “Facility kitchen and/or dining area is inaccessible to resident's”. The allegation alleged that the facility blocked the resident from entering the kitchen/ dining area. The allegation alleged that the residents were upset because they missed social dining. Department staff interview with the Administrator revealed a pipe leak in the kitchen area of the dining area. The Administrator stated that they had informed all the residents about the leak and that extensive repairs were required. The Administrator stated that dinner services were promptly moved to the activities room to maintain a social aspect of mealtime. LPA Nickolas’ interview with the Administrator revealed that the residents were temporarily moved to the activities room during the initial stages of the construction for a month or two (2). The finding is Unsubstantiated. There is no evidence or witnesses to corroborate the allegation. A finding of Unsubstantiated means although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation did or did not occur. An exit interview was conducted and copy of this report was providedthe state’s words, verbatim · CDSS document, May 16, 2023 · control 56-AS-20220819125545

Allegation investigated: Resident developed pressure injuries while in care Facility is in disrepair Facility staff is not properly trained

Licensing Program Analyst (LPA) Rayshaun Nickolas made an unannounced visit to the facility to deliver the finding on the above allegations. LPA met with Administrator Courtney Barreto and explained the purpose of the visit. The investigation included file reviews, a tour of the facility, and interviews with relevant parties. Allegation #1 “Resident developed pressure injuries while in care”. The reporting party (RP) alleged that resident #1 (R1) had pressure injuries when moved out of the facility. LPA interview with the administrator revealed that R1 did not have pressure injuries when they moved out of the facility. LPA interview with staff # 1 (S1) revealed that R1 did not have pressure injuries. LPA facility file review of R1’s records revealed no evidence that R1 had pressure injuries. The finding is Unsubstantiated. There is no evidence or witnesses to corroborate the allegation. Allegation #2 "Facility is in disrepair". The RP alleged that the kitchen sink in R1's room was leaking and had a puddle of brown/black liquid about 6" inches in diameter" under the kitchen sink. Unsubstantiated LPA interviews with facility staff revealed that the facility staff denied that the kitchen sink in R1's room was leaking and had a puddle of brown/black liquid under the sink. On 03/07/2023, LPA conducted a tour of the facility, including looking under the sinks in several residents' rooms, including R1's former room. LPA observed no leaks under any sinks (kitchen and bathroom) in the residents' room. LPA cannot attest to the facility's state when this allegation was made; therefore, the finding is unsubstantiated. There is no evidence or witnesses to corroborate the allegation. Allegation # 3 “Facility staff is not properly trained”. The RP alleged that an unknown staff member has no medical field training and is handling medication as a med tech. LPA interview with the administrator revealed that the staff's initial training includes 16 hours of on-the-job medication training. Per the administrator, the 16 hours include eight (8) hours of new hires shadowing the administrator or experienced med tech. LPA interview with the administrator revealed that during the eight (8) hours, the trainee would watch the med tech or administrator pop medication from the bubble pack, order medications, dispose of old bubble packs, and watch how to administer medication to the residents. LPA interview with the administrator also revealed that after the trainee has completed eight (8) hours of watching their trainer (administrator or experienced med tech), the trainee will receive eight (8) hours of hands-on training with a trainer present. LPA interview with the administrator revealed that in addition to the 16 hours of on-the-job training, there are also 20 hours of bookwork, watching videos, readings, and examinations to complete. LPA interview with the administrator further revealed that the 16 hours of on-the-job training is completed after the 20 hours of bookwork, watching videos, reading, and examinations are completed. LPA facility file review of staff employed at the facility when this allegation was made revealed that staff did receive training on handling medication. The finding is Unsubstantiated. There is no evidence or witnesses to corroborate the allegation. A finding of Unsubstantiated means although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation did or did not occur. An exit interview was conducted and copy of this report was provided.the state’s words, verbatim · CDSS document, Mar 7, 2023 · control 18-AS-20210224084519

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Victoria Chitgian made an unannounced visit to conduct an annual inspection focused on infection control. LPA met with Administrator Courtney Barreto and explained the purpose of the visit. LPA toured the facility and made observations regarding the infection control measures that the facility has implemented. LPA observed proper signs posted throughout the facility, sufficient hand hygiene supplies, sufficient cleaning and disinfecting provisions, and proper use of face coverings. The facility has an adequate amount of hand hygiene supplies (soap, hand sanitizer and paper towels). LPA observed a thirty (30) day supply of Personal Protective Equipment (PPE) which includes gloves, gowns, surgical masks, N95 masks, disinfectant, and hand sanitizer. PPE was stored in a hallway storage room. The facility has a plan in place which follows Community Care Licensing Division guidelines for testing, isolating and caring for residents with COVID-19 positive and/or exposures. There is a designated infection control lead person tasked with tracking all positive cases, ensuring PPE supplies are maintained, cleaning and disinfection provisions are in effect, and that staff are trained in the proper use and disposal of PPE. The facility staff monitors residents regularly for any changes in condition and daily symptom checks. The staff will contact the resident's physician in the event of any Covid-19 related illnesses. The staff are responsible for cleaning and disinfecting the highly touched surface areas during their shift. All staff and residents are practicing all other infection control precautions, which minimize the risk of them contracting Covid-19. LPA completed a walk-through of the facilities interior and exterior and there were no health and safety concerns. Based on the observations made during today’s visit, no deficiencies were cited per Title 22, Division 6, of the California Code of Regulations. An exit interview was conducted, and a copy of this report (LIC809) was provided to Administrator Courtney Barreto.the state’s words, verbatim · CDSS document, Dec 29, 2022

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Amy Goldenberg made an unannounced visit to the facility. The purpose of the visit was to conduct a required annual inspection, with an emphasis on infection control due to the COVID-19 pandemic. LPA is informed that there are no COVID positive individuals in the home. The facility has an approved mitigation plan on file with this agency. Precautionary Covid-19 postings are present at the front door. The staff are temperature screening visitors upon entry into the facility and asked to fill in a symptom questionnaire. All staff are observed to be wearing masks. LPA is advised that there are two (2) caregivers, one (1) activities director, and ten (10) residents present during this visit. LPA conducted a brief tour of the facility and made observations pertaining to the facility's infection control measures. The facility was equipped with sufficient hand hygiene supplies, sufficient cleaning and disinfecting provisions, and has a limited supply of Personal Protective Equipment (PPE). LPA discussed the availability of additional PPE supplies to the facility at the time of this visit and advised the facility representatives to contact our office in the event additional supplies are necessary. The facility continues to monitor client regularly for any changes in condition, and notify the client's physician and emergency personnel in the event the client presents any COVID-19 symptoms. Isolation procedures are in place. Hand sanitizer is available for resident and staff use at various points through out the facility. Each bedroom has their own restroom with a sink available for hand washing. Based on observations made during today’s inspection, there are no deficiencies being cited per Title 22, Division 6, of the California Code of Regulations. LPA reviewed this report with and a copy was provided to the facility representative.the state’s words, verbatim · CDSS document, Dec 28, 2021

Type of visit: Case Management - Health Checks

Licensing Program Analyst (LPA) Jennifer Semin made an unannounced visit to conduct a health and safety check. LPA met with Administrator, Alejandra Perdomo. Ms. Perdomo contacted the licensee Chiam Raskin via email and LPA spoke to Mr. Raskin via telephone. LPA Semin and Ms. Perdomo toured the facility inside and out and did not observe any immediate health and safety concerns during the tour. LPA and Mr. Raskin discussed submitting the documents to remove Vista Cove at Corona Inc. from the license. LPA provided Ms. Perdomo with a copy of the application instructions. Mr. Raskin stated he will submit all the required documentation to Centralized Applications Bureau (CAB) by end of business today 8/18/2021. Based on the information obtained during today's visit, there are no immediate threats to the health, safety, and welfare of the residents in care. No deficiencies were cited during today's visit. An exit interview was conducted where this report was discussed and provided to Ms. Perdomo.the state’s words, verbatim · CDSS document, Aug 4, 2021