Emerald Care Manor

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Jacqueline Shaw Ross made an unannounced visit to the facility to conduct an annual licensing inspection. LPA was met by Jamie Alido, Caregiver, and was granted entry into the facility. LPA spoke with Administrator, James Bandoy by telephone and discussed the purpose of the visit. He authorized Caregiver Alido to conduct the tour and sign off on inspection documents. A tour of the facility was conducted inside and out. LPA, accompanied by Ms. Alido, conducted a general overall inspection, which included but was not limited to the following: Facility physical plant, food service, medication management, record review and facility administration. The facility is licensed to serve six (6) elderly residents, all of whom may be non-ambulatory. A Hospice waiver is approved for two (2) residents. The facility is a five (5) bedroom two (2) bathroom one story house. One bedroom is shared two (2) to a room and the other four (4) bedrooms are private. During today's inspection, LPA observed the following: Indoor and outdoor passageways were observed to be free from obstruction. There are no pools or bodies of water. Per Ms. Alido, there are no firearms or other dangerous weapons in the facility. Poisons and cleaning agents were observed to be secured and inaccessible to residents in care. Facility fire clearance is maintained in conformity with State Fire Marshal regulations. LPA toured every room in the facility. Resident rooms had the required furnishings and sufficient lighting available. Facility provides each resident with clean linen, in good repair, and sufficient hygiene products for personal use. The hot water temperature measured at 107.9 degrees F. The facility had a functioning carbon monoxide detector, multiple smoke detectors, and multiple operable fire extinguishers. The facility was stocked with a two-day supply of perishable food items and a seven-day supply of nonperishable food items. Staff records were reviewed and contained CPR/First Aid training, Health Screening Reports, and annual training. Resident records were reviewed and had a current Physician's Report, Resident Appraisal, Identification and Emergency Information, Admission Agreement, and Centrally Stored Medication and Destruction Records. Medications were stored in a locked cabinet. During inspection of medication, LPA observed the following deficiency: Pre-packaged medication (bubble packaged medication) for R1 and R2 were removed from bubble pack and stored in medication pill trays. LPA advised Caregiver that pre-packaged medication must remain in its original container and cannot be transferred from one container to another. Deficiency cited. This report was discussed with Caregiver Jamie Alido and a copy of this report, LIC809D and Appeal Rights, was provided at the conclusion of the visit.the state’s words, verbatim · CDSS document, Oct 16, 2023

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Tricia Danielson arrived unannounced to the facility to conduct an annual inspection with emphasis on infection control. LPA met with Caregiver Jaime Avellaneda and explained the purpose of today’s visit. Licensee Jerri Bandoy arrived shortly thereafter. The facility has a Mitigation Plan Report on file as required however, an Infection Control Plan has not been received. The Licensee was granted a waiver under the authority of Governor Newsome's Executive Order N-11-22 issued on June 17, 2022, and the Licensee agreed to submit the Infection Control Plan by December 24, 2022. During the inspection, LPA inspected the facility for regulatory compliance related to infection control. LPA observed appropriate postings at the facility front entrance, including COVID-19 symptoms postings and visitation policies, which were in accordance with the Department's guidelines. LPA observed that the facility was also equipped with sufficient hand hygiene supplies, sufficient cleaning/disinfecting provisions, and a supply of Personal Protective Equipment (PPE). LPA observed facility staff wearing appropriate face coverings. The facility has a designated infection control lead person/infection preventionist who has been tasked with tracking all COVID-19 cases and/or suspected cases, ensuring staff are trained in the facility's infection control procedures, and ensuring infection control measures are implemented. The facility has a plan in place which follows Community Care Licensing Division guidelines for COVID-19 testing, isolation, and properly caring for residents and staff with COVID-19 positive results and/or exposures. The facility also has a plan in place to monitor residents regularly for any changes in condition and to subsequently notify the resident's physician, emergency personnel, and responsible party in the event the resident presents with any COVID-19 symptoms. No deficiencies were observed during today's visit. An exit interview was conducted, and a copy of this report was provided along with LIC9102- Technical Assistance.the state’s words, verbatim · CDSS document, Oct 24, 2022

The state marks this report as 3 pages; the online copy we transcribed has 1. You can request the full file from the county licensing office.