Golden Age

Type of visit: Required - 1 Year

On 08/16/2023 unannounced annual inspection was made to this facility by Licensing Program Analyst (LPA) Kimberly Viarella. The LPA identified herself and the purpose of the visit and asked to speak to the Designated Facility Administrator. LPA met Marinela Placintar, the Licensee. The Licensee informed this LPA that the Designated Facility Administrator, Elena Tritean's certification, # 6050936740, expired on 03/28/2023. The Administrator then provided this LPA with proof that the renewal training had been completed. The tour began with resident accommodations. Rooms were clean and had adequate furniture and lighting. There were 2 bathrooms. The LPA observed grab bars, non-skid surfaces, paper towels and soap in each. The hot water temperature was measured 112.8 degrees Fahrenheit and was in compliance. The LPA then inspected the kitchen and observed 7 days of non-perishable and 2 days of perishable food supplies. The pantry and refrigerator were also inspected and all items were packaged and dated appropriately. The LPA observed that the knives and sharps were all kept in a locked cabinet and inaccessible to residents in care at this time. LPA observed smoke and carbon monoxide detectors throughout the facility and the fire extinguisher was last inspected in 02/27/2023 by Jorgenson Co. Medications were stored in a locked closet and kept inaccessible to residents in care. The LPA inspected the medications and reviewed, storage, dosing and destruction procedures. The EMAR system and logs were also reviewed. Narcotics were kept in a locked box and stored in a refrigerator in the garage and inaccessible to residents in care. The LPA also inspected the First Aid kit which was found to be complete and in compliance. LPA completed a review of 4 staff files. All were up-to date with CPR and First Aid but were missing annual training. LPA also completed a review of 4 resident files. All were complete. LPA provided technical assistance regarding LIC 602 regarding access to hygiene items for residents in care as well as the requirements for fire clearance. According to California Code of Regulations, Title 22, there was one deficiency observed and cited today on the LIC 809 D page. A copy of this report and Appeal Rights were provided to the Licensee. Exit interview.the state’s words, verbatim · CDSS document, Aug 16, 2023

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Sarah Hurt conducted an unannounced visit today for the facility’s annual inspection. LPA met with Facility Staff Kenroy Anderson and explained the purpose for today's visit. Continual Administrator's Certification for Marinela Placintar expires . There are currently 6 residents who reside at this home and there is 2 residents on hospice at this time. LPA inspected the interior and the exterior of the facility including the common living spaces, resident bedrooms and bathrooms, activity rooms, medication storage, kitchen, garage and outdoor areas. Bedrooms were clean and in good repair. There is a locked storage for medications. Food supply is adequate for 2-day perishable and 7-day nonperishable. Fire extinguisher is within the safety regulation period. Smoke alarms were tested and are operational. The home has a carbon monoxide detector and performs disaster drills as required. Water temperature was tested at degrees. First Aid kit is on site and complete. Toxins and cleaning supplies are locked and inaccessible. LPA confirmed all staff present has vaccination cards or exemptions. LPA confirmed all staff present is background cleared. Facility Administrator Marinela Placintar's Administrator's Certificate expired on 06/23/2022. LPA's observed staff did not screen at entrance for COVID 19 symptoms or ask screening questions. The following deficiencies are being cited during today's inspection per California Code of Regulations, Title 22. LPA's requested the following documents: LIC 500 Personnel Report, LIC 308 Designation of Administrative Responsibility, LIC 610-E the Emergency Disaster Plan and copy of current Administrator’s Certificate to update the facility file. Listed documents shall be sent to Licensing. Exit interview conducted with Administrator Marinela Placintar and copy of report left at facilitythe state’s words, verbatim · CDSS document, Jul 11, 2022

Type of visit: Case Management - Deficiencies

Licensing Program Analyst (LPA) Jason Lund made an unannounced visit on this day for the purpose of conducting a Case Management visit. LPA me with Licensee Marinela Placintar and explained the reason for the visit. On 6/9/2021 an Office meeting was held with the Licensee Marinela Placintar, the RO and DSS Auditors. During the meeting, the RO explained audit finding and expectation of financial monitoring for one year. Licensee Placintar was advised of documents needing to be provided to the Audits Department along with the dates expected to submit to the Department. The Audits Department also sent email on 1/6/2022 to Licensee Placintar reminding of the documents needed. The documents required for the solvency monitoring are as follows: 1. LIC 401-Monthly operating statement for Golden Age 5 & 6 & 10; 2. The food receipts showed the food delivered to Golden Age 10. How many residents reside at Golden Age 10 located at 3213 Inverness St, Modesto, CA; 3. Electricity Bill dated in August 2021; 4. Water Bills for the period July – September /2021 for all the facilities; 5. Bank statement account ending 3545 for July 1 – July 31/2021; 6. Xfinity Cable bills for the period July – September /2021 for all the facilities; 7. Water bills for the period July – September /2021 for all the facilities; 8. Food receipt for Golden Age 1 _ September 2021. These documents were to be submitted quarterly and were due for the third quarter on October 15, 2021. As of this date, these documents have not been received. During the visit LPA Lund & Licensee Marinela Placintar discussed the facility changing from a sole individual to a corporation. LPA stated to Licesee Marinela Placintar any type of changing the facility with have to go through Central Applications Bureau (CAB). The following deficiencies were cited per Title 22, Division 6 of the California Code of Regulations. An exit interview was conducted with and a copy of this report along with appeal rights was provided.the state’s words, verbatim · CDSS document, Jan 26, 2022

From the deficiency page — Deficiency type: Type B · Section cited: CCR 87755(c) · Plan of correction due date: Feb 4, 2022

The licensing agency shall have the authority to inspect, audit, and copy resident or facility records upon demand during normal business hours. Records may be removed if necessary for copying. Removal of records shall be subject to the requirements in Sections 87412(f), 87506(d), and 87508(b). This requirement is not met as evidenced by:Based on the auditor not getting the requested paperwork. This posed a potential health and safety risk to residents in care.the state’s words, verbatim · CDSS document, Jan 26, 2022

Plan of correction: The Licesnee will email, LPA, LPM & Auditor the requested paperwork by 2/4/2022.

Type of visit: Case Management - Health Checks

Licensing Program Analyst (LPA) Sarah Hurt conducted an unannounced case management visit to the facility on 12/30/2021 at 9:00 a.m. LPA met with Administrator Marinela Placintar and explained the purpose for today's visit. There are 6 residents currently living at the facility and 2 residents are currently on hospice care. LPA toured the facility kitchen, bathrooms, and bedrooms. LPA observed 2 days perishable food in the refrigerator, and 7 days non perishable in facility pantry. LPA observed working gas, electricity, and warm water at the facility. LPA observed locked medication cabinet with sufficient supply of medications for facility residents. LPA observed sufficient staff working at the facility. LPA interviewed the two staff members working at the facility both stated they had no concerns at this time and are being paid correctly on time twice a month. LPA requested Administrator Marinela submit the documents below to CCL Auditors within two days. 1. LIC 401/401A Form for the month of September 2021. 2. LIC 403/403 A Form for the month of September 2021. 3. All utility monthly billing statements including cable, water, garbage, electricity and gas for the period from July 2021 to September 2021. 4. Monthly Bank Statements for period from July 2021 to September 2021. 5. All food receipts for all the facilities for period from July 2021 to September 2021 6. Rental Roll including resident name and rental payment for the period from July 2021 to September 2021. There were no deficiencies observed or cited during today's inspection per California Code of Regulations, Title 22. An exit interview was conducted with facility Administrator Marinela Placintar and a copy of this report was left at the facility.the state’s words, verbatim · CDSS document, Dec 30, 2021

Type of visit: Required - 1 Year

Licensing Program Analysts (LPA) Sarah Hurt conducted an unannounced visit today for the facilities annual inspection. LPA met with Administrator Marinela Placintar. Administrator's Certification expires 06/23/2022. There are currently 5 residents who reside at this home and there is 4 residents on hospice at this time. LPA inspected the interior and the exterior of the facility including the common living spaces, resident bedrooms and bathrooms, activity rooms, medication storage, kitchen, garage and outdoor areas. Bedrooms were clean and in good repair. There is a locked storage for medications. Food supply is adequate for 2-day perishable and 7-day nonperishable. Fire extinguisher is within the safety regulation period. Smoke alarms were tested and are operational. The home has a carbon monoxide detector and performs disaster drills as required. Water temperature was tested at 116.7 F degrees. First Aid kit is on site and complete. Toxins and cleaning supplies are locked and inaccessible. There were no deficiencies observed or cited during today's inspection per California Code of Regulations, Title 22. LPA's requested the following documents: LIC 500 Personnel Report, LIC 308 Designation of Administrative Responsibility, LIC 610-E the Emergency Disaster Plan and copy of current Administrator’s Certificate to update the facility file. Listed documents shall be sent to Licensing. Exit interview conducted with Administrator and copy of report left at facilitythe state’s words, verbatim · CDSS document, Aug 10, 2021

Type of visit: Office

An office meeting was conducted today in the Sacramento Regional Office via WebEx. The purpose of this meeting was to discuss audit compliance. Present at the meeting was Regional Manager (RM) Krystall Moore, Licensing Program Manager (LPM) Stephenie Doub, Jacqueline Juarez and Lisa Ni, DSS Auditors, and Marinela Placintar, Licensee. On November 5, 2020 an Office meeting was held to discuss the audit findings. It was agreed during the Office meeting that the licensee would provide monthly documentation to the audit department for solvency monitoring. The documents required are as follows: · LIC 401 · LIC 402 · Rent roll · Utility statements · Food receipts · Monthly and quarterly bank statements The Licensee furnished documents for the 3rd quarter of 2020 which showed non-sufficient fund payments, water bills not paid timely and food costs below the required food requirements. The Licensee agreed that payments may have been late in 2020, but that she has corrected the problem by setting up automatic payments for the accounts. The licensee further explained that all food receipts may not have been provided, which may be the reason for the low food costs. It was agreed that to better understand the financial solvency of the facility, the licensee would provide all requested documents for the 2nd quarter of 2021 (April, May and June) to DSS Audits section by July 31, 2021.Tthe Licensee was encouraged to reach out to the Department should there be any questions regarding receipts to submit. An exit interview was conducted with Licensee Marinela Placintar and copy of this report was provided via email.the state’s words, verbatim · CDSS document, Jul 21, 2021