Diya Senior Care Home

Allegation investigated: Resident had access to hazardous object. Staff is not providing a comfortable environment for resident. Staff did not prevent inappropriate interactions between residents.

Licensing Program Analyst (LPA) Steve Chang conducted an unannounced complaint Investigation visit to deliver the investigation findings, and met with administrator(ADM) Bani Kaur. On 12/06/2021, the Department received a complaint with the above allegations. On 12/10/2021, LPA Steve Chang conducted an initial 10 day inspection/investigation, and met with ADM. LPA interviewed ADM, 1 staff (S1) and 5 residents (R1 - R5). LPA requested resident's Physician’s Report, Appraisal/Needs and Service Plan and incident reports. LPA toured the facility with ADM. Continued on 9099-C. Page 1 of 3. Unsubstantiated Resident had access to hazardous object: On 12/10/2021, LPA reviewed the documents, an incident happened on 10/20/2021, a suspect resident (SR1), acted aggressively, and yelled to other resident. 911 was called by the facility, and SR1 was sent to Emergency Psychiatric Service (EMS) immediately. No one was hurt. On 12/10/2021 and 08/04/2022, LPA interviewed Administrator (ADM) and staff S1, both of them stated the residents could not access the knives. They stated knives were locked by the facility, and no resident had the key. They stated they never saw any resident accessed the knives in the facility. On 12/10/2021, LPA interviewed 5 residents (R1 - R5). None of them stated they could access the facility knives, and none of them stated they saw other residents accessed the knives. On the same days, LPA toured the facility inside out, and observed the facility knives were locked. On 9/21/2022, LPA interviewed 5 residents (R1 - R5). 5 Out of 5 stated they never saw any resident held the knife and threatened other residents. 5 Out of 5 stated they could not access the knives in the facility. On the same day, LPA interviewed ADM. ADM stated only the staff have the keys to access the knives in the facility. On 11/1/2022, LPA interviewed R1 and R2. They stated SR1 acted aggressively in the incident, but they did not see SR1 held the knives. Based on the investigation, observation, and interviews conducted, the facility knives were observed locked, all the residents stated they could not access the knives. All the residents stated they did not observe any resident held the knives. ADM and S1 stated no residents could access the knives. Continued on 9099-C. Page 2 of 3. Staff is not providing a comfortable environment for resident: Staff did not prevent inappropriate interactions between residents: On 12/10/2021 and 08/04/2022, LPA interviewed ADM and S1. Both them stated only resident SA1 had the aggressive behavior. ADM and S1 stated all other residents have no any history of aggressive behavior. ADM stated SA1 moved out from the facility on 10/21/2021. ADM stated the facility has the house rules to regulate residents' behaviors. ADM and S1 stated if the facility staff find the resident has the inappropriate or aggressive behavior, the staff will separate the aggressive resident from other residents immediately to protect other residents, and will redirect and to stabilize him/her. On 12/10/2021 and 9/21/2022, LPA interviewed 5 residents (R1 - R5). None of them stated they felt unsafe in the facility. All of them stated they never saw any resident held the knife and threatened other residents. All of them stated only SR1 had the aggressive behavior, and SR1 already moved out on 10/21/2021. None of them stated they were hit by other residents or hit by staff. All of them stated they never saw the altercations between residents. ADM provided LPA the email logs with social workers and psychiatric agency that ADM claimed that the facility tried the best to provide help to stabilize SA1. ADM stated the facility could not confirm that SA1 was stable, so the facility did not let SA1 came back to the facility. ADM stated the facility tried the best to provide a comfortable environment for resident. Based on the records reviewed and interviews conducted, the facility provided the supervision of care to residents. The facility took action on the resident's aggressive behavior. The facility tried the best to protect the residents. Based on investigation, observations, and interviews conducted, the Department found that the above allegation is UNSUBSTANTIATED. An unsubstantiated finding indicates that although the allegation may have happened or is valid, there is not a preponderance of evidence to prove that the allegations did or did not occur. No citations noted at today’s complaint investigation visit. Exit interview was conducted with ADM. This report was provided to ADM.the state’s words, verbatim · CDSS document, Dec 12, 2022 · control 26-AS-20211206154910

Allegation investigated: Resident sustained a fracture while in care.

Licensing Program Analyst (LPA) Steve Chang conducted an unannounced complaint visit today to deliver the investigation findings of the above allegations and met with Administrator (ADM) Bani Kaur. On 4/22/2022, the Department received a complaint that the facility resident sustained a fracture while in care. On the same day, LPA conducted initial 10 day inspection/investigation, and met with ADM, staff and residents. LPA obtained the following facility records: resident's physician report, appraisal needs and service plan, admission agreement, medical records, and incident reports. Continued on 9099-C. Page 1 of 2. Unfounded Resident sustained a fracture while in care: On 4/22//2022, the Department reviewed R1's incident reports (IRs) dated 4/16/2022 and 4/18/2022, R1 had two separate fall accidents in the facility on 4/16/2022 and 4/18/2022. According to IRs, on 4/16/2022 R1 lost his/her balance and fell in the restroom. R1 was immediately sent to hospital, and was discharged on the same day. While on 4/18/2022, R1 attempted to pick up his/her water bottle from bed side, and fell on the floor and hurt his/her lower back. R1 was immediately sent to the hospital. On 6/13/2022, the Department obtained hospital medical records of R1. Based on medical record reviews, R1 had prior lumbar injuries. Based on R1's appraisal, R1 was ambulatory with no need for assistance. On 8/4/2022, LPA interviewed ADM, and two staff (S1, S2). All of them stated R1 had falls on 4/16/2022 and 4/18/2022, and was sent to hospital. ADM and S1 stated R1 had Lumbar injuries before R1 was admitted in the facility. Based on records reviewed and interviews conducted, R1 had lumbar injuries prior admission to the facility. R1 was ambulatory with no need for assistance for walking. The two fall incidents were un-witnessed, it happened in the restroom and in R1's bedroom. The Department has investigated the above allegations. Based on the investigation, observations, records reviewed, and interviews conducted, the Department found that the above allegations are UNFOUNDED, meaning that the allegation is false, could not have happened and/or is without a reasonable basis. No citations noted at today’s compliant investigation visit. Exit interview was conducted with ADM. This report was provided to ADM for signature. Facility is not sanitary: On 08/04/2022, LPA conducted an investigation/inspection visit of the facility. During visit, LPA toured and inspected the following areas in the facility: living room, dining room, kitchen, 3 bedrooms and 2 bathrooms. During the inspection, LPA did not observe feces on the wall of residents' bedrooms. LPA observed bedrooms with no feces or smell. On 8/04/2022, LPA interviewed staff (S1) and 5 residents (R1 - R5). S1 stated the facility staff check and clean the resident bedrooms everyday. S1 denied there were feces on the wall of residents' bedrooms on 4/16/2022. All of 5 residents did not complain that the facility was unsanitary. Based on investigation, observations, and interviews conducted, the Department found that the above allegation is UNSUBSTANTIATED. An unsubstantiated finding indicates that although the allegation may have happened or is valid, there is not a preponderance of evidence to prove that the allegations did or did not occur. No deficiencies or citations noted at today’s compliant investigation visit. Exit interview conducted with ADM. A copy of this report was provided to ADM.the state’s words, verbatim · CDSS document, Nov 18, 2022 · control 26-AS-20220422092403

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Steve Chang conducted an unannounced annual inspection visit, and met with Administrator (ADM) BHUPINDER KAUR. Upon arrival, ADM took LPA body temperature, and checked LPA in the visitor log book. LPA toured the facility inside out with ADM. COVID posters were observed at main entrance and the facility. Screening station with masks, hand sanitizer, glove, thermometer and visitor log book was observed at the main entrance. Living room, kitchen, dinning room and two restrooms were inspected. All trash cans were observed with covers. One of the restroom did not have posters of washing hands. ADM stated ADM will put the posters of washing hands for 20 seconds in restroom in 3 days. No paper towel was observed in kitchen. Cloth towel were observed in kitchen. ADM stated ADM will put paper towels with holder in kitchen in 3 days. Three shared resident bedrooms, and laundry room were inspected. Two day perishable food supplies and seven day nonperishable food supplies were observed sufficient. Medication closet, knives closet, and cleaning product closet were observed locked. Room temperature was at 80 degree F, and hot water temperature was at 108 degree F in facility. 5 residents were observed in facility. Fire extinguisher was serviced on 09/08/2022. Front yard and backyard were inspected. There was no obstruction to block the walkways. The facility already submitted the Infection Control Plan to LPA. No citation were noted today. Exit interview was conducted with ADM. This report was provided to ADM for signature.the state’s words, verbatim · CDSS document, Sep 9, 2022

Type of visit: Required - 1 Year

At 3:35PM, Licensing Program Analyst (LPA) Steve Chang arrived at the facility, and met with administrator (ADM) Bhupinder Kaur. ADM conducted an infection control/prevention screening, and took LPA body temperature, then log LPA into the guest log book. LPA toured the faculty with ADM inside out. There are 3 client shared rooms, 2 restrooms at the first floor. There are two staff live-in rooms, one restroom, and ADM's office room on the second floor. LPA inspected kitchen, living room, and dinning room. LPA observed 6 clients (C1 - C6) in the facility. LPA observed another staff (S1) in the facility. The beds in the shared rooms were observed 6 feet apart. LPA inspected the food supplies, Two days perishable foods and seven non perishable foods were observed sufficient. Fire extinguisher's date was observed valid. Not all the trash cans were with covers in facility. ADM stated the facility will replace them to be trash cans with covers. LPA observed no paper towel with holder in the kitchen. ADM stated the facility will fix this issue with 3 days. The current roasters of staff and clients were obtained. Medication closet was observed locked. LPA inspected the PPE supplies. PPE supplies were observed sufficient. LPA discussed and reviewed LIC808, mitigation plan, with ADM. ADM stated the facility will follow the COVID protocol. No citation was issued for today's inspection. Exit interview was conducted with ADM. This report was provided to ADM to review and to sign. A copy of this report was emailed to ADM.the state’s words, verbatim · CDSS document, Sep 15, 2021