Daniella's Home

Type of visit: Required - 1 Year

On 10/19/23, Licensing Program Analyst (LPA), Wendy Gibbs, conducted an unannounced annual visit using the full CAREs tool. LPA met with Administrator, Bessie Coronado-Vigil, and explained the purpose of today’s visit. Currently there are 4 Clients residing in the facility. Structure/Physical Plant The facility is a two-story home in a residential neighborhood. The home consists of 4 bedrooms, 2 ½ bathrooms, family room, living room, kitchen, dining room, indoor and outdoor activity area, laundry room, front yard, and backyard. There is a shaded area with table and chairs. LPA observed a fenced pool on the premises. All walkways around the facility were observed to be clean, clear, and free of obstructions, hazards, and debris. Bedrooms LPA inspected all client bedrooms and found them to be clean and in good repair. All rooms have the required furniture including a bed, dresser, nightstand, chair, and storage space for personal belongings. LPA observed all beds to have the required linens including a mattress cover, fitted sheets, blankets, comforter, and pillows. All bedrooms have ample lighting. Bathrooms LPA inspected all bathrooms and found they were within Title 22 regulations. All bathrooms were observed clean and operational. LPA observed an adequate supply of towels and personal hygiene supplies. Secured handrails and non-skid mats were observed in both bathrooms. Kitchen LPA observed the kitchen to be clean and sanitary. All appliances were tested and found to be in good working repair. LPA observed an ample supply of cutleries, pots, and pans in good repair. LPA observed a 3-day supply of perishable foods and a 7-day supply of nonperishable foods. A sample menu was posted on the refrigerator. All sharps were secured in a locked drawer in the kitchen and are inaccessible to client. All cleaning supplies were secured in a locked cabinet in the activity room and are inaccessible to clients. The water temperature measured 108.8-degrees Fahrenheit. Common Rooms In the living room, LPA observed two couches and chairs for client use. In the family room, LPA observed a couch available for clients. LPA observed games and activities in the family room. The dining room has a large table and chairs to accommodate all clients. LPA observed all walkways and hallways to be clean, clear, and free of obstructions and hazards. All rooms were observed with ample lighting. The facility was maintained at a comfortable temperature. Safety Smoke and Carbon Monoxide Detectors are in compliance and are operational. LPA observed two fully charged fire extinguishers last serviced on 08/25/23. The last emergency drill was conducted on 08/25/23. The First Aid Kit was inspected and found to contain all required item and a manual. The facility has a working landline telephone. LPA observed all required documents posted throughout the facility. There are no firearms stored on the premises. Files/Interview LPA reviewed 2 client files and found they contained the required documents. When interviewed, clients stated they were happy with the care they are receiving at the facility. LPA reviewed 2 staff files and found they contained the required documents, certification, and training. LPA interviewed 2 staff and all were able to answer questions regarding policy, procedures, and personal rights. Infection Control LPA observe the facilities infection control procedures. LPA observed a sanitizing station and visitor log at the entrance of the facility. All clients, staff and visitors’ temperature is taken and logged upon entry. LPA observed staff wearing face coverings. All required infection control signs were posted throughout the facility. The facility has a 30-day supply of PPEs. Medication LPA observed Centrally Stored Medications secured in a locked cabinet in the activity room and are inaccessible to clients. LPA reviewed medications and MAR for 2 clients and found them to be consistent. During today’s visit no deficiencies were observed or cited. An exit interview was conducted with Administrator, Bessie Coronado-Vigil, and a copy of this report was provided.the state’s words, verbatim · CDSS document, Oct 19, 2023

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Jeremiah Randle conducted an unannounced Annual inspection visit and infection control inspection to the above facility. LPA was later met by Bessie L Coello Administrator the purpose of today’s visit was explained. There are currently (4) Regional Center consumers in placement. All (4) clients are ambulatory. The facility is a two-story structure located in a residential neighborhood. It consists of the following: 4 bedrooms, 2 bathrooms, family room/office, living room, kitchen, dining room, shaded area, indoor and outdoor activity area, laundry room in no garage. LPA and Administrator toured the entire facility inside and out. Documents are posted as mandated by the DPH and CCLD. Bedrooms 1 – 4 are occupied by clients, all contained the mandated furniture. The (2) bathrooms are clean and operational. Smoke detectors and carbon monoxide detector are in compliance and operational. No firearms are stored at facility, body of water present in the form of a pool which is screened. Medications are stored, locked and inaccessible to clients. 1 staff file is current, 1 resident file is current along with medications. The water temperature is at 180.1 degrees. A comfortable temperature is maintained in the facility. Ample supply of perishable and nonperishable food, linens and personal hygiene supplies are adequate, hazardous toxins and/or items are inaccessible to clients, 2 fire extinguishers are charged. LPA received the following documents from the administrator, Client Roster, Employee Roster, Liability Insurance, Fire Prevention Ins, Stipulation and Waiver and Order unsigned, Copy of Floor Plan LPA will continue inspection at a later date no citations issued at this time. An exit interview conducted with Bessie L Coello, Administrator and copy of report provided.the state’s words, verbatim · CDSS document, Nov 16, 2022

Type of visit: Required - 1 Year

On 10/19/2021, Licensing Program Analyst (LPA) Don Senaha conducted an unannounced annual required visit with a primary focus on Infection Control measures using the new CARE Inspection Tool. LPA met with caregiver Natalia Torres and explained the purpose of today’s visit. The facility is licensed to operate for six (6) non-ambulatory elderly residents ages 60 and above. The facility is approved for one (1) bedridden and two (2) hospice. The facility is a two-story structure located in a residential neighborhood. The second story is not used as part of the facility. The first story consists of the following: four (4) resident's rooms, two (2) bathrooms, two living room areas, dining area and kitchen. There is a detached garage space used for the recreation room with a bathroom. There is a refrigerator and laundry area with a sink in the recreation room. There is a shaded patio area with ample seating for the residents. LPA and caregiver toured the physical plant. There is a swimming pool enclosed by a fence and is inaccessible to residents. No other bodies of water or obstructions on the premises. All rooms were inspected. Beds and bedding supplies were in good condition, adequate lighting provided, storage for resident personal belongings was observed. Bed linens, comforters, and bath towels were adequately stocked at the time of visit. Bathrooms were found to be within Title 22 regulations and were clean and operational. The water temperature measured between 108.2 F to 115.6 F in the kitchen and bathrooms. A comfortable temperature of 74 degrees was maintained in the facility. Evaluation Report Continues on LIC 809-C. LPA observed the facility to be sanitary and appropriately furnished at the time of visit. Storage areas for personal hygiene, cleaning supplies, toxins, and sharps objects were stored and not accessible to residents. The kitchen was inspected and there is sufficient perishable and non-perishable food available maintained properly. Two (2) fire extinguishers were fully charged, one in the kitchen area and one in the recreation room. First aid kit was available. Smoke detectors and carbon monoxide were operable. A review of Medication Administration Records (MAR) was maintained in order and accurate. During the visit, LPA observed the facility infection control practices. LPA observed screening protocols for visitors, staff, and residents, sanitizing stations in common areas and restrooms. LPA observed staff wearing face coverings, LPA observed four (4) clients and one (1) staff present during the tour. LPA observed the facility has a 30-day supply of Personal Protective Equipment (PPE). All mandated inspection control posters were posted. Advisory Notes – One (1) Technical Assistance were issued, please see LIC9102-AN. No deficiencies were cited during this inspection visit. An exit interview was conducted and a copy of this report will be emailed to Bessie Coello.the state’s words, verbatim · CDSS document, Oct 19, 2021

The state marks this report as 3 pages; the online copy we transcribed has 2. You can request the full file from the county licensing office.

Allegation investigated: Resident sustained an injury from a fall while in care

On 09/1/2021, Licensing Program Analyst (LPA) Stephanie Cifuentes conducted an unannounced initial complaint visit at this facility. LPA met with Natalia Torres, House Manager and explained the purpose of today's visit is to conduct an investigation regarding the allegations listed above. The investigation consisted of the following: LPA interviewed Administrator Bessie Coelho. Interviews were conducted with two (2) staff and four (4) residents (R1-R4). LPA inspected the facility. LPA reviewed records for residents 1-4 (R1-R4) along with the current staff/resident roster and other documents in association with the allegations. Continued on 9099-C Unsubstantiated INVESTIGATION REVEALED THE FOLLOWING: Allegation: Resident sustained an injury from a fall while in care The complainant alleges that on 8/21/2021 R1 was found on bathroom floor and received an injury due to a fall. LPA Cifuentes reviewed incident report sent by facility for date 8/20/2021, that was faxed to Community Care Licensing. The report states that R1 was in bathroom with S1, when R1 called S1 to let them know something was occurring as they were voiding. S1 turned around to assist R1. Per incident report, R1 did not fall while in bathroom. LPA interviewed staff (S1) who was on shift the evening of the incident. Per S1, R1 did not fall, they were escorted to the bathroom by staff, who turned to give R1 privacy. R1 told S1 that something was wrong, so S1 immediately turned and took note of the situation and called 911. At no time during incident did R1 fall. Reporting parties’ statement is inconsistent with what was reported by S1 during interview as well as report on incident provided by facility to Community Care Licensing. LPA interviewed resident R1, who stated they had fallen but it was a long time ago. Interviews with administrator and S2 also indicate that while R1 is a fall risk, they did not sustain a fall in the bathroom on 8/21/2021 or on 8/20/2021. Based on information gathered, the Department did not find sufficient evidence to support the allegation mentioned above. The Department’s investigation consisted of an inspection of the facility, observation, analysis of resident records, incident report, and interviews conducted and found no evidence to support the allegation: “Resident sustained an injury from a fall while in care”. Although the allegations may have happened or are valid, there is not a preponderance of evidence to prove the alleged violations, did or did not occur, therefore the allegations are Unsubstantiated. An exit interview was conducted with Bessie Coelho and a copy of the report was provided.the state’s words, verbatim · CDSS document, Sep 1, 2021 · control 11-AS-20210827151400