Esther Care Home

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Cassie Yang arrived at the facility to conduct a Required 1- year annual inspection utilizing the full CARE tool. LPA met with Caregiver, Abigail Ndukwe, who informed LPA Administrator is not at the facility. LPA entered the facility and contacted Administrator. Administrator arrived to the facility approximately 25 minutes later. LPA and Administrator discussed the importance of Inspection Authority of Licensing Agency and criminal clearance transfer request. LPA and Administrator conducted a tour of the interior and exterior of the facility. LPA observed the presence of four residents in care, LPA was informed there is no resident in care under hospice services. LPA and Administrator toured four private residents room, one shared resident room, caregiver room, two bathroom, kitchen, office, storage room, backyard and common areas. LPA observed the facility to have 2+ days of perishable and 7+ days of non-perishable food. LPA observed toxins, sharps and medication to be locked and secured in the kitchen. LPA observed the fire extinguisher to last service on 01/11/2023. LPA observed temperature of the facility to be 77*. LPA conducted a file review of 3 out of 4 residents file. LPA was unable to inspect 1 out of 2 personnel files. LPA and Administrator discussed that all over the counter medications are to be approved and ordered by physician. LPA requested a copy LIC500, LIC308 and liability insurance to be emailed to LPA by Friday September 22, 2023 at 5PM. As a result of today's inspection, deficiencies observed. See LIC 809-D. Exit interview. Copy of the report and appeal rights provided.the state’s words, verbatim · CDSS document, Sep 20, 2023

The state marks this report as 4 pages; the online copy we transcribed has 2. You can request the full file from the county licensing office.

Type of visit: Case Management - Incident

On 5/4/2023, Licensing Program Analysts (LPA) Cassie Yang arrived at the facility unannounced to conduct a case management visit regarding an incident report the Department received on 5/3/2023. LPA met with caregiver, Tarachin Elliot, and explained the purpose of the visit. Caregiver then contacted Administrator (Admin), Charles Eguavoen, who arrived to the facility shortly afterwards. The facility is currently licensed for (6) non-ambulatory, hospice waiver of 2. During today's visit, there are (3) residents, and no residents on hospice services. At LPA's arrival, LPA observed the fire door on the right wing to be propped open with a door stopper from the bottom. LPA observed caregiver removing it prior to Admin's arrival. During today's visit, LPA and Admin discussed the importance of contacting emergency medical services when a resident is injured and/or falls. Additionally, LPA provided Admin a copy of CCR 87203 Fire Safety. As a result of today's inspection, deficiencies were cited. Civil penalty assessed. Please see LIC 809-D. Exit interview conducted and a copy of the report and appeal rights was left at the facility.the state’s words, verbatim · CDSS document, May 4, 2023

From the deficiency page — Deficiency type: Type A · Section cited: CCR 87465(a)(2) · Plan of correction due date: May 5, 2023

87465 Incidental Medical and Dental Care (a) A plan for incidental medical and dental care shall be developed by each facility. The plan shall encourage routine medical and dental care and provide for assistance in obtaining such care, by compliance with the following: (2) The licensee shall provide assistance in meeting necessary medical and dental needs. This includes transportation which may be limited to the nearest available medical or dental facility which will meet the resident's need. This requirement is not met as evidenced by: Based on record review and interview, Licensee did not ensure residents in care received medical attention in a timely manner as LPA was informed R1 fell at 3:35 AM and dislclosed her back hurts, but was not sent to the emergency room until approximately 7:15AM, which poses an immediately risk to the residents in care.the state’s words, verbatim · CDSS document, May 4, 2023

Plan of correction: Licensee agrees to provide training for all direct care staff on the requirement to seek medical attention timely for residents. Licensee will schedule the training and provide CCL with the training content and signed staff attendance sheet as proof of correction by 5/5/2023.

From the deficiency page — Deficiency type: Type A · Section cited: CCR87203 · Plan of correction due date: May 5, 2023

87203 Fire Safety All facilities shall be maintained in conformity with the regulations adopted by the State Fire Marshal for the protection of life and property against fire and panic. This requirement is not met as evidenced by: Based on observation, Licensee did not ensure facility was in compliance as LPA observed the fire door located on the right wing to be propped open with a door stopper, which poses an immediate risk to the residents in care.the state’s words, verbatim · CDSS document, May 4, 2023

Plan of correction: LPA observed caregiver removing the door stop and closed the door immediately. Licensee is to notify all staff that the fire door must remain closed at all time. Licensee is to submit a letter of compliance of CCR 87203 to CCL by 5/5/2023. ***$500.00 Immediate Civil Penalties issued today.

Type of visit: Case Management - Other

On 4/6/2023, Licensing Program Analysts (LPA's) Cassie Yang and Sarah Benson arrived at the facility unannounced to conduct a case management visit. LPAs met with Administrator (Admin) and explained the purpose of the visit. The facility is currently licensed for (6) non-ambulatory, hospice waiver of 2. During today's visit, there are (3) residents and 0 resident on hospice services. During today's visit, LPA's and Admin toured the interior of the facility to ensure the health and safety of residents in care. In areas toured, no immediate health and safety violation observed. LPA's observed (3) residents in their private rooms. LPA observed the staff room to be vacant. Admin informed LPA that Admin and his wife are the only ones utilizing the staff room during NOC shifts. LPA's and Admin discussed staffing shortage at the facility. Admin informed LPA's he has not posted position openings but waiting on staff recommendations. As a result of today's inspection, no deficiencies cited. Exit interview conducted and a copy of the report was left at the facility.the state’s words, verbatim · CDSS document, Apr 6, 2023

Type of visit: Case Management - Annual Continuation

Licensing Program Analyst (LPA) Cassie Yang arrived at the facility to conduct a case management annual continuation, utilizing the infection control domain. LPA met with caregiver, Donna Marie Neveus and explained the purpose of the visit. Caregiver contacted Administrator immediately. Today's census is 4. There is (1) resident on hospice services, facility has a hospice waiver of (2). Administrator arrived to the facility at 2:55 PM. LPA and Administrator conducted a tour of the facility. In areas toured included but not limited to: kitchen, dining room, resident bedrooms, bathroom, staff room, and common areas. LPA observed the facility to be at 75*. LPA observed the fire extinguisher to be serviced 01/11/2023. LPA observed the facility to have 2+ days of perishable foods and 7+ days of non-perishable foods. LPA observed medication and toxics to be locked and secured but observed the knife drawer was not. LPA observed the up to date Administrator Certificate posted by entrance. LPA and Administrator discussed the possibility of removing fire doors. LPA stated she will provide Metro Fire contact information to Administrator. At this time, deficiencies were observed. Please see LIC 809-D. Exit interview conducted and a copy of the report and appeal rights will be provided to Administrator via email.the state’s words, verbatim · CDSS document, Feb 28, 2023

From the deficiency page — Deficiency type: Type B · Section cited: CCR 87309(d)(1) · Plan of correction due date: Mar 10, 2023

87309 Storage Space (a) Disinfectants...and other items which could pose a danger if readily available to clients shall be stored where inaccessible to clients. (1)Storage areas for... other dangerous weapons shall be locked. Tbhis requirement is not met as evidenced by: Based on observation, Licensee did not ensure dangerous items were inaccessible as LPA observed the knife drawer to be unlocked, which poses a potential risk to residents in care.the state’s words, verbatim · CDSS document, Feb 28, 2023

Plan of correction: Knife drawer was locked immediately. Licensee is to get technical support as Administrator informed LPA ,the facility has been non-operating for some time and will need refreshers on Title 22..

Type of visit: Required - 1 Year

On 10/31/2022, Licensing Program Analyst (LPA) Cassie Yang at the facility unannounced to conduct an annual inpsection. LPA observed the driveway to be empty. LPA looked through the window and observed the facility to be empty. LPA contacted the facility number at 916-560-3800 and there was no answer. LPA will return at a later date to complete annual inspection.the state’s words, verbatim · CDSS document, Oct 31, 2022

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Melana Llopis met Licensee, Charles Eguavoen at the facility to conduct an annual inspection on 08/24/2021. Prior to visit, LPA completed required COVID-19 testing protocols, and a daily self-screening questionnaire for symptoms of COVID-19 infection to affirm no COVID-19 related symptoms; upon visit completed a facility risk assessment. LPA ensured they applied hand sanitizer before entering the facility and the following Personal Protective Equipment (PPE) was worn: Surgical Mask. LPA was informed by licensee that there have been no residents in this facility since June 2021, as the residents who were in the this facility at that time transferred to another facility in Roseville, CA area. LPA and licensee toured the physical plant together. LPA observed the facility to have gas and electricity. Administrator informed LPA they received their annual fee for their licensee in the mail two (2) days ago and will pay before the due date on 10/02/2021. Facility has a non-perishable food supply on hand and licensee ensured LPA perishable food would be obtained prior to admitting residents again. Facility has locked storage area for medications, knives, toxins, and confidential records. LPA observed bedrooms for resident use have required furnishings. Showers for resident use have required grab bars and non-slip surfaces. Water temperature in the bathroom measured at 105 degrees F, which is within range. LPA observed smoke and carbon monoxide detectors throughout the facility and observed a fire extinguisher that is fully charged and last serviced 10/29/2020. LPA observed one (1) of five (5) resident bedrooms to need the carpet replaced due to incontinent stains and foul odor. Licensee provided proof to LPA of new carpet installment and stated they will not be accepting any new residents prior to the new installment. LPA will follow up regarding the new carpet installment prior to Licensee accepting any new residents. Licensee stated that he will notify CCL upon admitting any new residents into the facility. LPA and licensee reviewed infection control procedures. Exit interview held and copy of report provided to Licensee.the state’s words, verbatim · CDSS document, Aug 24, 2021

The state marks this report as 2 pages; the online copy we transcribed has 1. You can request the full file from the county licensing office.