Drock Home Care

Allegation investigated: Staff interferes with resident phone calls Facility does not meet resident's nutritional needs Resident's bedroom exit door is obstructed Facility does not assist resident with incontinence care Licensee inappropriately increased resident's facility rate fees

On 05/11/2023, Licensing Program Analyst (LPA) Perry Scott conducted a continuation of a complaint visit that was done on 02/03/2022. LPA Scott met with Licensee, Rukayat Adamson, and explained the purpose of this visit is to deliver findings from a previous complaint. On 2/3/2022, Licensing Program Analyst (LPA) Martessa Brown conducted a complaint investigation regarding the above listed allegations. LPA met with staff Funmilola Lawal-DSP and was later met by Adamson Rukakyat, the facility Administrator and the purpose of today's visit was explained. On 02/03/2022, the investigation consisted of the following: During today’s visits LPA toured the entire facility. LPA reviewed Clients #1-2 Admissions Agreement, Physicians Reports. medication cabinet/medication records and Residents Roster. LPA requested the following documents: Lic 500 Residents Appraisals, Needs & Services, Incontinence care policy & procedures and activity calendar by 2/7/2022. R#1, R#2,R#3 & R#4. LPA interviewed Resident R#1, R#2,R#3 & R#4. LPA attempted to interview R#5. Report continued on LIC9099-C Unsubstantiated The investigation revealed the following: Regarding allegation #1: Staff interferes with resident phone calls. On 05/10/23 at 10:00am, LPA interviewed S1. S1 denied the allegation that the Staff interferes with resident phone calls. S1 stated that whenever any of the residents receive personal phone calls, they are given their privacy. And at no time does anyone interfere or eaves drop on any residents’ telephone calls. On 05/10/23, LPA interviewed S2 about the allegation that the Staff interferes with resident phone calls. S2 stated that when residents get phone calls, S2 asks who it is, verifies who they would like to speak to, and then gives the telephone to the resident. S2 says, “ I don’t listen to their phone calls, I give them their privacy”. On 05/10/23, LPA interviewed R1-R6 about the allegation that Staff interferes with resident phone calls. Residents R1-R2 denied the allegation and confirmed that when they get phone calls, they are given their privacy to speak alone. R3-R6 was not able to be interviewed due to cognitive impairment issues. Based on interviews there is insufficient evidence to support the allegation: Staff interferes with resident phone calls. 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, therefore the allegation is Unsubstantiated. Regarding allegation #2: Facility does not meet resident's nutritional needs. On 05/10/23 at 10:00am, LPA interviewed S1. S1 denied the allegation that the Facility does not meet resident's nutritional needs. S1 stated that the facility has a varied menu plan. It consists of protein, vegetables, fruits, and grains. S1 also stated that all the meals are nutritious. LPA observed the menu posted in the kitchen and it seems to be a varied and nutritional offering. On 05/10/23, LPA interviewed S2 about the allegation that the Facility does not meet resident's nutritional needs. S2 denied the allegation and asserted that the facility does offer a wide variety of nutritional meals as shown in the menu plan. LPA observed the refrigerator and its contents and there were lots of leafy greens, vegetables, milk, eggs, and meats. LPA also observed the pantry area, and it provided a mix of pantry staples. On 05/10/23, LPA interviewed R1-R6 about the allegation that the Facility does not meet resident's nutritional needs. Residents R1-R2 denied the allegation and confirmed that they are served nutritional meals and are satisfied with the food. R3-R6 was not able to be interviewed due to cognitive impairment issues. However, LPA observed that they seemed healthy, and were having breakfast when the LPA arrived. Based on interviews, observations, and record reviewed there is insufficient evidence to support the allegation: Facility does not meet resident's nutritional needs. 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, therefore the allegation is Unsubstantiated. Report continued on LIC9099-C Regarding allegation #3: Resident's bedroom exit door is obstructed. On 05/10/23 at 10:00am, LPA interviewed S1. S1 denied the allegation that the Resident's bedroom exit door is obstructed. S1 stated that there are no obstructions that block the residents’ door nor their exit. LPA did a walk-through of the facility and did not observe any obstructions blocking the exits of any of the residents’ doors. On 05/10/23, LPA interviewed S2 about the allegation that the Resident's bedroom exit door is obstructed. S2 denied the allegation. LPA did a walk-through of the facility and did not observe any obstructions blocking the exits of any of the residents’ doors. On 05/10/23, LPA interviewed R1-R6 about the allegation that the Resident's bedroom exit door is obstructed. Residents R1-R2 denied the allegation that there were any obstructions blocking their bedroom door. R3-R6 was not able to be interviewed due to cognitive impairment issues. LPA did a walk-through of the facility and did not observe any obstructions blocking the exits of any of the residents’ doors. Based on interviews and observations there is insufficient evidence to support the allegation: Resident's bedroom exit door is obstructed. 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, therefore the allegation is Unsubstantiated. Regarding allegation #4: Facility does not assist resident with incontinence care. On 05/10/23 at 10:00am, LPA interviewed S1. S1 denied the allegation that the Facility does not assist resident with incontinence care. S1 stated we check on the residents throughout the day. Those that need to be turned, we turn them side to side every two hours. Those that need their diapers changed, we do it 3 or 4 times throughout the day, or as needed if they are wet. Some residents need to be check on more often throughout the day. But we do assist the residents with incontinence care. Additionally, there is a hospice nurse that comes in as well to make sure their needs are being met. On 05/10/23, LPA interviewed S2 about the allegation that the Facility does not assist resident with incontinence care. S2 denied the allegation and stated the residents are assisted with their incontinent care. S2 stated that S2 checks on the residents’ many times throughout the day to make sure they are not wet. On 05/10/23, LPA interviewed R1-R6 about the allegation that the Facility does not assist resident with incontinence care. Residents R1-R2 denied the allegation and confirmed that they are assisted with incontinence care by the staff. R3-R6 was not able to be interviewed due to cognitive impairment issues. LPA did a walk-through of the residents’ bedrooms and did not detect any unpleasant smells due to the lack of incontinence assistance. Based on interviews and observations there is insufficient evidence to support the allegation: Facility does not assist resident with incontinence care. 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, therefore the allegation is Unsubstantiated. Report continued on LIC9099-C Regarding allegation #5: Licensee inappropriately increased resident's facility rate fees. On 05/10/23 at 10:00am, LPA interviewed S1. S1 denied the allegation that the Licensee inappropriately increased resident's facility rate fees. S1 stated that S1 never inappropriately increased the residents rate fees. S1 stated that the facility sent out a 60-day notice to the residents’ representative advising them that a rate increase would occur. The residents’ representative complained of the increase and said they were not going to pay it. S1 stated that S1 is willing to work with the representative if there is an issue of a hardship but the representative is unwilling to speak to me. And as of today, I have not actually increased the resident’s rate. On 05/10/23, LPA interviewed S2 about the allegation that the Licensee inappropriately increased resident's facility rate fees. S2 denied knowing anything about that issue. S2 is only a caregiver and doesn’t have access to that information. On 05/10/23, LPA interviewed R1-R6 about the allegation that the Licensee inappropriately increased resident's facility rate fees. Residents R1-R2 denied the allegation and confirmed that their rate fee was not inappropriately increased. Moreover, R1 stated that R1s rent hasn’t been increased. R3-R6 was not able to be interviewed due to cognitive impairment issues. Based on interviews, observations, and record review there is insufficient evidence to support the allegation: Licensee inappropriately increased resident's facility rate fees. 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, therefore the allegation is Unsubstantiated. No deficiencies were cited. An exit interview has been conducted and a copy of the Complaint Report provided to Licensee, Rukayat Adamson.the state’s words, verbatim · CDSS document, May 11, 2023 · control 11-AS-20220126154054

Allegation investigated: Resident is being retaliated against. Resident is not being provided activities. Resident is being financially abused while in care.

On 05/11/2023, Licensing Program Analyst (LPA) Perry Scott conducted a continuation of a complaint visit that was done on 02/03/2022. LPA Scott met with Licensee, Rukayat Adamson, and explained the purpose of this visit is to deliver findings from a previous complaint. On 2/3/2022, Licensing Program Analyst (LPA) Martessa Brown conducted a complaint investigation regarding the above listed allegations. LPA met with staff Funmilola Lawal-DSP and was later met by Adamson Rukakyat, the facility Administrator and the purpose of today's visit was explained. On 02/03/2022, the investigation consisted of the following: During today’s visits LPA toured the entire facility. LPA reviewed Clients #1-2 Admissions Agreement, Physicians Reports. medication cabinet/medication records and Residents Roster. LPA requested the following documents: Lic 500 Residents Appraisals, Needs & Services, and activity calendar by 2/7/2022. LPA interviewed Resident R#1, R#2,R#3 & R#4. LPA attempted to interviews R#5. Report continued on LIC9099-C Unsubstantiated The investigation revealed the following: Regarding allegation #1: Resident is being retaliated against. On 05/10/23 at 10:00am, LPA interviewed S1. S1 denied the allegation that the Resident is being retaliated against. S1 stated that at no point in time has anyone, me or my staff has ever retaliated against a resident for filing a complaint; or because someone filed on their behalf. It is my practice to sit down with my residents and try to resolve any conflict that arises in the facility. Moreover, I try to resolve any conflict with the representatives of the residents. On 05/10/23, LPA interviewed S2 about the allegation that the Resident is being retaliated against. S2 denied the allegation and asserted that they are not retaliating against any resident. S2 stated that they try and treat each resident with respect no matter the conflict. On 05/10/23, LPA interviewed R1-R6 about the allegation that Resident is being retaliated against. Residents R1-R2 denied the allegation and confirmed that they are receiving proper treatment and have no issues with the staff. And have not been retaliated against for any complaint made by them or their representative. R3-R6 was not able to be interviewed due to cognitive impairment issues. LPA observed the residents in care and noticed that they all seemed to be happy with no discernable issues. Based on interviews, observations, and records reviewed there is insufficient evidence to support the allegation: Resident is being retaliated against. 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, therefore the allegation is Unsubstantiated. Regarding allegation #2: Resident is not being provided activities. On 05/10/23 at 10:00am, LPA interviewed S1. S1 denied the allegation that Resident is not being provided activities. S1 stated that we provide a variety of activities for the residents. I try to take them on weekly car rides to the park to get them out of the facility. Additionally, we provide exercise activities to keep them healthy. We have puzzles, games, and I try to keep them active by having them walk around the facility with me to keep their strength up. Additionally, all of the residents that can participate, they do. However, those that don’t want to participate I don’t force them to do anything they don’t want to do. LPA observed a calendar of activities posted in the facility. On 05/10/23, LPA interviewed S2 about the allegation that the Resident is not being provided activities. S2 denied the allegation and stated that the facility provides a number of different activities for the residents. For instance, we play card games, there are puzzles, also we take them on car rides to the park. On 05/10/23, LPA interviewed R1-R6 about the allegation that the Resident is not being provided activities. Residents R1-R2 denied the allegation and confirmed that the facility does provide activities for the resident. R1 stated that R1 does not participate because R1 is bedridden. R3-R6 was not able to be interviewed due to cognitive impairment issues. Based on interviews, observations, and records reviewed there is insufficient evidence to support the allegation: Resident is not being provided activities. 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, therefore the allegation is Unsubstantiated. Regarding allegation #3: Resident is being financially abused while in care. On 05/10/23 at 10:00am, LPA interviewed S1. S1 denied the allegation that the Resident is being financially abused while in care. S1 stated that one of the representatives for a resident believes that I am financially abusing a resident because I stated that I was going to be increasing the basic rate services. I have a right to do that it is in the admission agreement, and I also issued a 60-day notice of the increase. Additionally, the representative said I was financially abusing the resident because I was not providing incontinence items. Per the admission agreement, the family is required to do that. However, I keep a personal supply for times when the family is short. I supply it to the resident only until they can supply their own. Plus, the resident complains about the diapers the representative brings and prefers mine because mine is of a higher quality. I am not nor have I ever financially abused a resident while in care. On 05/10/23, LPA interviewed S2 about the allegation that the Resident is being financially abused while in care. S2 denied the allegation and stated that none of the residents have complained of being financially abused. And to my knowledge they are not. On 05/10/23, LPA interviewed R1-R6 about the allegation that the Resident is being financially abused while in care. Residents R1-R2 denied the allegation and confirmed that the facility is not financially abusing them. R3-R6 was not able to be interviewed due to cognitive impairment issues. Based on interviews, observations, and records reviewed there is insufficient evidence to support the allegation: Resident is being financially abused while in care. 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, therefore the allegation is Unsubstantiated. No deficiencies were cited. An exit interview has been conducted and a copy of the Complaint Report provided to Licensee, Rukayat Adamson.the state’s words, verbatim · CDSS document, May 11, 2023 · control 11-AS-20220203121216

Allegation investigated: Facility staff are not providing resident medication when needed. Facility staff are not following resident's care plan. Facility staff do not provide resident care checks for extended periods of time. Facility staff leave resident in heavily soiled briefs.

On 05/11/2023, Licensing Program Analyst (LPA) Perry Scott conducted a continuation of a complaint visit that was done on 05/10/2023. LPA Scott met with Licensee, Rukayat Adamson, and explained the purpose of this visit is to deliver findings from a previous complaint. On 5/10/2023, at 9:26am, Licensing Program Analyst (LPA) Perry Scott conducted a complaint investigation regarding the above listed allegations. LPA met with Licensee, Rukayat Adamson and the purpose of today's visit was explained. On 05/10/2023, the investigation consisted of the following: During today's visit LPA conducted a health & Safety check of the entire facility. LPA conducted interviews with the Licensee, Rukayat Adamson (S1), staff (S2), and residents R1-R2, LPA attempted to interview R3-R6 but was not able to at the time of the visit. LPA requested and obtained copies of the following documents: Resident & Staff roster, physicians report, meal plans, activity calendar, ID/Emergency information, and admissions agreement. Report continued on LIC9099-C Unsubstantiated The investigation revealed the following: Regarding allegation #1: Facility staff are not providing resident medication when needed. On 05/10/23 at 10:00am, LPA interviewed S1. S1 denied the allegation that the Facility staff are not providing resident medication when needed. S1 stated that all of prescribed medications are given according to the doctor’s prescription and given on the specific days and times indicated. Additionally, S1 stated that at no time have they not adhered to those orders. LPA observed the medication for all residents and did not observe anything unusual in the dosage or delivery of such medication. On 05/10/23, LPA interviewed S2 about the allegation that the Facility staff are not providing resident medication when needed. S2 denied the allegation and asserted that they are following what the doctor has prescribed for each of the residents. And that all medications given with the dates and times are noted in the Medication Administration Record. LPA did not observe any discrepancies in the record. On 05/10/23, LPA interviewed R1-R6 about the allegation that Facility staff are not providing resident medication when needed. Residents R1-R2 denied the allegation. R3-R6 was not able to be interviewed due to cognitive impairment issues. LPA reviewed the records and did not observe any discrepancies in the record. Based on interviews, observations, and records reviewed there is insufficient evidence to support the allegation: Facility staff are not providing resident medication when needed. 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, therefore the allegations are Unsubstantiated. The investigation revealed the following: Regarding allegation #2: Facility staff are not following resident's care plan. On 05/10/23, LPA interviewed S1. S1 denied the allegation that Facility staff are not following resident's care plan. S1 stated that the facility is following the hospice care plan. The hospice caregivers come 3 times weekly to give care, diaper change, wound care, and refill all medications that are needed. Additionally, a nurse comes two other times throughout the week to bathe the resident. And the days that hospice does not come; the staff does the incontinence care, turning of the client, bathing, and any other items that need to be addressed by the facility. On 05/10/23, LPA interviewed S2 about the allegation that the Facility staff are not following resident's care plan. S2 denied the allegation and asserted that they are following the care plan that hospice has implemented and has not deviated from it. S2 stated that hospice comes a varied number of times throughout the week to take care of the resident and the facility provides care for those days that hospice is not available for the additional days of the week. On 05/10/23, LPA interviewed R1-R6 about the allegation that the Facility staff are not following resident's care plan. Residents R1-R2 denied the allegation. LPA observed that the residents seem healthy, clean, and living in sanitary conditions. R3-R6 could not be interviewed due to their cognitive impairment issues. LPA observed that the residents seemed to be healthy, clean, nourished, and in good spirits. Report continued on LIC9099-C Based on interviews, observations, and records reviewed there is insufficient evidence to support the allegation: the Facility staff are not following resident's care plan. 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, therefore the allegations are Unsubstantiated. The investigation revealed the following: Regarding allegation #3: Facility staff do not provide resident care checks for extended periods of time. On 05/10/23, LPA interviewed S1. S1 denied the allegation that the Facility staff do not provide resident care checks for extended periods of time. S1 stated that all care checks are done throughout the course of the day, and that there is someone at the facility 24 hours a day. In addition, the facility has a monitoring app that’s placed outside the room of each client to ensure compliance with monitoring of the resident. LPA observed the app that monitors the outside of the rooms of the residents and found it to be reliable. On 05/10/23, LPA interviewed S2 about the allegation that the Facility staff do not provide resident care checks for extended periods of time. S2 denied the allegation and stated that they are always monitoring the residents and their well-being while in the facility. Additionally, S2 stated that S2 checks on the residents every couple of hours and more if needed, depending on the resident and their needs. On 05/10/23, LPA interviewed R1-R6 about the allegation that the Facility staff do not provide resident care checks for extended periods of time. Residents R1-R2 denied the allegation and confirmed that they are receiving care checks throughout the day. While R3-R6 could not be interviewed due to their cognitive impairment , LPA did observe that they seemed healthy, clean, and living in sanitary conditions. Based on interviews, observations, and records reviewed there is insufficient evidence to support the allegation: the Facility staff do not provide resident care checks for extended periods of time. 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, therefore the allegations are Unsubstantiated. Report continued on LIC9099-C The investigation revealed the following: Regarding allegation #4: Facility staff leave resident in heavily soiled briefs. On 05/10/23, LPA interviewed S1. S1 denied the allegation that the Facility staff leave resident in heavily soiled briefs. S1 stated that all residents are provided care checks 3 or 4 times a day, or as needed to determine if they need to be changed or have their incontinence issues attended to. S1, additionally stated that all residents are different and have different care needs throughout the day, and that certain residents are checked on more often that others given their specific care needs. But at no time are any of the residents left in heavily soiled briefs. On 05/10/23, LPA interviewed S2 about the allegation that the Facility staff leave resident in heavily soiled briefs. S2 denied the allegation and stated that they are always monitoring the residents and checking to see if they have soiled their briefs. And anytime they notice this they change the resident immediately and get them into dry undergarments or diapers. LPA observed the residents seemed to be clean, and no smell was noticed at the time of the investigation. On 05/10/23, LPA interviewed R1-R6 about the allegation that the Facility staff leave resident in heavily soiled briefs. Residents R1-R2 denied the allegation and confirmed that they are changed when they need to be changed and that they are never left in soiled briefs for an extended period of time. R3-R6 could not be interviewed due to their cognitive impairment , but LPA did observe that they seemed healthy, clean, and living in sanitary conditions. Based on interviews, observations, and records reviewed there is insufficient evidence to support the allegation: the Facility staff leave resident in heavily soiled briefs. 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, therefore the allegations are Unsubstantiated. No deficiencies were cited. An exit interview has been conducted and a copy of the Complaint Report provided to Licensee, Rukayat Adamson.the state’s words, verbatim · CDSS document, May 11, 2023 · control 11-AS-20230504155137

Type of visit: Required - 1 Year

On 03/30/23, Licensing Program Analyst (LPA) Perry Scott conducted an unannounced annual required visit using the new Cares Inspection Tool. LPA met with licensee, Rukayat Adamson and explained the purpose of the visit. The facility is licensed to serve residents age range 60 and over, six (6) ambulatories, of which 6 may be non-ambulatory and a hospice waiver for 4. The current resident census is six (6). The facility has an outstanding balance of $742.00 for annual fees due, which include a late payment penalty. The facility is a single-story structure located in a residential neighborhood. It consists of the following: 5 bedrooms ( three (3) resident bedrooms and 2 staff rooms), (2) bathrooms ((1) staff and (1) resident bathroom), living room, dining room, kitchen, attached two car garage, and back yard patio with table and six chairs. Each resident bedroom has two residents residing. LPA toured the physical plant with licensee. There were no 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 client 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 hot water temperature measured 109.3 degrees Fahrenheit. A comfortable temperature was maintained in the facility. 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 clients. The kitchen was inspected and there is sufficient perishable and non-perishable food available maintained properly. LPA observed that the fire extinguisher was charged. The smoke detectors and carbon monoxide are operable. Fire Drills were observed to be maintained in order and accurate. Last fire drill was conducted on 3/14/23. Exits/ Walkways around the home were free of debris and hazards. Report continued on LIC809-C Medications were centrally stored and properly locked, first aid kit was checked and fully stocked with manual. Client and staff files were reviewed. All staff are fingerprint cleared and associated to the facility and have documentation of the required trainings on file. However, the staff member did not have a health screening in the personnel file and is being cited for that deficiency. LPA conducted a records review of (6) client records, (1) staff records, and reviewed the facility disaster plan. All client & staff records were complete, minus a health screening. The facility disaster plan was current and in compliance with Title 22 at the time of visit. LPA reviewed (6) Client Medication Administration Records and did not observe any discrepancies at the time of visit. During the visit, LPA observed the facility's infection control practices. LPA observed screening protocols for visitors, staff, and residents, sanitizing stations in common areas and restrooms. LPA observed staff were wearing face coverings, LPA observed the facility has a 60-day supply of Personal Protective Equipment (PPE). All mandated inspection control posters were posted. A review of staff and resident temperature logs were reviewed. The following deficiencies were cited during this visit: 87411(f) Personnel Requirements-General (No health screening for staff member) An exit interview was conducted, and a copy of this report was provided to Licensee, Rukayat Adamsonthe state’s words, verbatim · CDSS document, Mar 30, 2023

Type of visit: Required - 1 Year

On 05/14/22, at 10:15 am, Licensing Program Analyst (LPA)/ Susan Campos conducted an unannounced annual required visit with a primary focus on Infection Control measures using the new CARE Inspection Tool. LPA was allowed entry into the facility by Rukayat Adamson, Administrator. LPA met with licensee and administrator Rukayat Adamson and explained the purpose of the visit. The facility is licensed to operate residents age range 60 and over, six (6) ambulatory of which 6 may be non-ambulatory and hospice waiver for 4. Last fire drill conducted on 4/26/22. The facility is a single-story structure located in a residential neighborhood. It consists of the following: 5 bedrooms ( three (3) resident bedrooms and 2 staff rooms), (2) bathrooms ((1) staff and (1) resident bathroom), living room, dining room, kitchen, attached two car garage, and back yard patio with table and six chairs. Each resident bedroom has two residents residing. LPA toured the physical plant with Administrator Ms. Adamson. There were no 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 client 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 hot water temperature measured 105.9 degrees Fahrenheit. A comfortable temperature of 73 degrees was maintained in the facility. 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 clients. The kitchen was inspected and there is sufficient perishable and non-perishable food available maintained properly. The fire extinguisher is charged. The smoke detectors and carbon monoxide are operable. Fire Drills were observed to be maintained in order and accurate. Evaluation Report Continues on LIC 809-C During the visit, LPA observed the facility's infection control practices. LPA observed screening protocols for visitors, staff, and residents, sanitizing stations in common areas and restrooms. LPA observed staff were wearing face coverings, LPA observed the facility has a 30-day supply of Personal Protective Equipment (PPE). All mandated inspection control posters were posted. A review of staff and resident temperature logs were reviewed. No deficiencies were cited during this inspection visit. An exit interview was conducted and a copy of this report was provided to Administrator Rukayat Adamson.the state’s words, verbatim · CDSS document, May 14, 2022

Allegation investigated: Staff are harassing residents authorized representative regarding payment

***This report serves as an amendment to report created on 4/22/2022 . This report supersedes the complaint investigation findings reflected on report created 4/22/2022.*** On 4/22/2022 at 1:25pm, Licensing Program Analyst (LPA)/ Susan Campos, initiated a 10-day complaint investigation visit for the allegation listed above. LPA was allowed entry into the facility by Administrator Rukayat Adamson. LPA explained to Ms. Adamson the purpose of the visit. The investigation consisted of the following: On 4/22/2022, LPA and Administrator conducted an inspection of the facilities’ physical plant, LPA conducted an interview with Administrator; and LPA was provided the following documents: LIC 500-Staff Roster; Client Roster; R1’s Admission Agreement; and R1’s Physician Report. The investigation revealed the following: Regarding the allegation: “Staff are harassing residents authorized representative regarding payment.” On 4/22/2022 interviews conducted by LPA indicates that the complaint allegation did not involve R1 but involved a third party LPA was informed by Administrator that on 4/13/22, she sent a text message to R1’s POA, informing that an outstanding rent payment was due. ” We have found that the complaint was unfounded, meaning that the allegation was false, could not have happened and/or is without reasonable basis. We have therefore dismissed the complaint.An exit interview was conducted with Rukayat Adamson, Administrator and a hard copy of a LIC 9099 and LIC 9099D was provided. Unfoundedthe state’s words, verbatim · CDSS document, Apr 22, 2022 · control 11-AS-20220418162850

From the deficiency page — Deficiency type: Type B

This LIC 809D report serves as an amendment to report created on 4/22/2022 . This report supersedes the LIC 809D report created on 4/22/2022. Complaint findings Unfouned, No deficiences cited.the state’s words, verbatim · CDSS document, Apr 22, 2022

Allegation investigated: Illegal eviction.

On 3/25/2022 at 2:34pm, Licensing Program Analyst (LPA)/ Susan Campos, initiated a 10-day complaint investigation visit for the allegation listed above. LPA was allowed entry into the facility by Administrator Rukayat Adamson. LPA explained to Ms. Adamson the purpose of the visit. The investigation consisted of the following: LPA and Ms. Adamson conducted an inspection, for health and safety of the facilities’ physical plant, and food supply, LPA conducted an interview with Administrator Rukayat Adamson, and LPA was provided the following documents from Administrator Rukayat Adamson: LIC 500-Staff Roster; Client Roster; R1 Admission Agreement; and R1 Physician Report. LPA was informed by Administrator Rukayat Adamson that she did not provide R1’s POA with an eviction notice, and has not proceeded with any eviction action for R1. Per investigation, LPA will identify deficiency and citation on a Case Management LIC 809. Based on information gathered, LPA did not find sufficient evidence to support allegation " Illegal Eviction”. Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violations did or did not occur, therefore the allegation is Unsubstantiated. An exit interview was conducted with Rukayat Adamson, Administrator, and a LIC 9099 hard copy was provided. Unsubstantiatedthe state’s words, verbatim · CDSS document, Mar 25, 2022 · control 11-AS-20220323122257

Type of visit: Case Management - Other

This report serves as an amendment to report created on 3/25/2022 . This report supersedes the case management complaint investigation findings reflected on LIC 809 report created on 3/25/2022. On 3/25/22, at 3:52 pm, Licensing Program Analyst/ LPA Campos conducted a case management visit. LPA was allowed entry to the facility by Administrator Rukayat Adamson. LPA Campos explained to Ms. Adamson the purpose of the visit. According to the California Code of Regulations (Title 22, Division 6, Chapter 8), LPA did not observe deficiencies therefore no citations were issued at this time. Exit interview conducted with Administrator Adamson.the state’s words, verbatim · CDSS document, Mar 25, 2022