Golden Age VII

Type of visit: Required - 1 Year

On 06/22/2023, Licensing Program Analyst (LPA) Arielle Pascua arrived unannounced to this facility to conduct an annual visit. LPA was greeted by staff member (SM), Nadia Falconer and explained the purpose of the visit. LPA asked that SM Falconer call the Facility Designated Administrator to inform them that CCL was present at this time. Shortly after, LPA met with Licensee, Marinela Placintar and Facility Designated Representative (FDR), Kenroy Anderson. There was one other staff member present at the time of this visit, Colin Falconer. This facility is licensed to serve 6 residents, of which all may be non-ambulatory. This facility has a hospice waiver for 3 and has a dementia program on file. Current census was 5. A brief interview with Licensee Placintar was conducted. LPA reviewed 5 resident files. 5 out 5 resident files were current and up to date. LPA reviewed 3 staff files. 3 out 3 staff files were current and up to date. The facility administrator has a current and active administrator certificate. A tour of the facility was conducted. The interior of the physical plant was in good condition and sanitary. Fire extinguishers appeared to have been annually inspected by Jorgenson Co on 02/27/2023. The kitchen area was toured. LPAs observed a non-perishable and perishable foods in the cabinets and refrigerator. Additional perishable food supplies were identified in the garage. LPA observed a locked centralized stored medication cabinet located in the kitchen. Along with the administrator, the LPA observed, reviewed, and compared resident medication and medication dispensing logs. First Aid Kit was present and contained all of the required components. A tour of the bathrooms was conducted. Hot water temperature was measured and observed to be within the required range of 105-120 degrees. A linen closet was located in the hallway and presented a sufficient amount of linens to adequately supply and meet the needs of the residents at this time. A tour of the bedrooms was conducted. Resident furniture was observed to be sufficient to meet their needs at this time. Laundry area was toured. Laundry detergent, bleach, and all other cleaning supplies were observed to be locked and made inaccessible to the residents at this time. Common areas were toured. Living room, dining area and all other areas intended for resident use were observed to be furnished and maintained in compliance at this time. A tour of the garage was conducted. Additional perishable food supplies were identified. The exterior of the physical plant was toured. Perimeter fence was observed to be stable and gates were in good repair. The following forms and documents were requested to be updated and submitted into CCL -LIC 308 -LIC 400 -LIC 500 -LIC 610 As a result of this visit, no deficiencies were observed or cited during this annual visit. An exit interview was conducted and copy of the 809 and 809-C was provided to Licensee, Marinela Placintar.the state’s words, verbatim · CDSS document, Jun 22, 2023

Type of visit: Case Management - Other

An unannounced plan of correction visit was conducted on 07/11/2022 by Licensing Program Analysts (LPAs) Arielle Pascua and Avellina Martinez. LPA Arielle Pascua and LPA Avellina Martinez met with the designated, authorized representative, Kenroy Anderson and explained the purpose of today's visit. The purpose of this visit was to clear the deficiencies that were cited on the last annual visit on 06/22/2022. During this visit LPAs toured the facility and it was discovered that the laundry room was left open with accessible toxins. It was also observed that two people were not wearing masks and hand sanitizer dispenser was empty. One deficiency was not cleared LPA observed front window screen was not repaired. The screen was bend and not properly sealed allowing for air to come through into the facility. Facility staff was informed an immediate civil penalty of $1,200 was assessed for a violation of Section 8088(b) on 07/11/2022. This civil penalty was due to not clearing Plan of Correction (POC) that was not cleared by POC date 06/29/2022. Facility staff was informed an immediate civil penalty of $500 was assessed for a violation of Section Health and Safety Code 1569.50(a)(3) on 07/11/2022. As a result of this visit, deficiencies were cited per California Code of Regulations, Title 22 and Health and Safety Code. Exit interview was conducted, and a copy of 809, 809D, and appeals rights were given to the facility at the end of visit.the state’s words, verbatim · CDSS document, Jul 11, 2022

From the deficiency page — Deficiency type: Type A · Section cited: CCR 87309(a) · Plan of correction due date: Jul 12, 2022

87309(a) Storage Space Disinfectants, cleaning solutions, poisons, firearms and other items which could pose a danger if readily available to clients shall be stored where inaccessible to clients. This requirement was not met as evidence by based on observation Licensee did not ensure toxins were accesible to residents in care. LPAs observed toxins unlocked in laundry room. This posed an immediate health and safety risk for residents in care.the state’s words, verbatim · CDSS document, Jul 11, 2022

Plan of correction: Licensee agrees to lock laundry room and made toxins inaccesible to the residents in care. POC was cleared at the time of visit.

From the deficiency page — Deficiency type: Type A · Section cited: HSC1569.50(a)(3) · Plan of correction due date: Jul 12, 2022

Health and Safety Code 1569.50(a)(3) Conduct Inimical: Conduct which is inimical to health, morals, welfare or safety of either an individual in, or receiving services from the facility or the people of the State of California. This requirement was not met as evidenced by based on observation the facility did not implement mask mandate for both staff and visitors. This poses an immediate health and safety risk to residents in care.the state’s words, verbatim · CDSS document, Jul 11, 2022

Plan of correction: Facility Staff agrees to: to train all staff on covid-19 precautionary measures by POC Date 07/12/2022.

Type of visit: Required - 1 Year

An unannounced annual visit was conducted by Licensing Program Analysts (LPAs) Charlie Yang and Arielle Pascua. LPAs met with caregiver, Colin Falconer, who was asked to call the facility designated administrator at the time. LPAs met with Kenroy Anderson shortly after. One other staff member was present, Nadia Falconer. LPAs met with the Licensee shortly after, Marinela Placintar. This facility has a hospice waiver for 6 and a dementia program on file. The current census was 6 residents. A tour of this facility was conducted. The interior of the physical plant was in good condition and sanitary. Fire extinguishers appeared to have been annually inspected by Jorgenson Co on 03/22/2022. The kitchen area was toured. LPAs observed a non-perishable and perishable foods in the cabinets and refrigerator. Additional perishable food supplies were identified in the garage. LPAs observed a locked centralized stored medication cabinet located in the kitchen. Along with the administrator, the LPAs observed, reviewed, and compared resident medication and medication dispensing logs. First Aid Kit was present and contained all of the required components. A tour of the bathrooms was conducted. Hot water temperature was measured and observed to be within the required range of 105-120 degrees. A linen closet was located in the hallway and presented a sufficient amount of linens to adequately supply and meet the needs of the residents at this time. A tour of the bedrooms was conducted. Resident furniture was observed to be sufficient to meet their needs at this time. Laundry area was toured. Laundry detergent, bleach, and all other cleaning supplies were observed to be locked and made inaccessible to the residents at this time. Common areas were toured. Living room, dining area and all other areas intended for resident use were observed to be furnished and maintained in compliance at this time. A tour of the garage was conducted. Additional perishable food supplies were identified. The exterior of the physical plant was toured. Perimeter fence was observed to be stable and gates were in good repair. The following forms and documents were requested to be updated and submitted into CCL -LIC 308 -LIC 400 -LIC 500 -LIC 610 The following deficiencies were observed and cited on the following LIC 809-D pursuant to Title 22 Rules and Regulations, Health and Safety Code. Appeal rights were printed and a copy was given to the facility designated Administrator. Exit Interview.the state’s words, verbatim · CDSS document, Jun 22, 2022

Type of visit: Office

An office meeting was conducted today in the Sacramento Regional Office via Microsoft Teams. The purpose of this meeting was to discuss the 3rd quarter 2021 audit findings. Present at the meeting was Regional Manager (RM) Krystall Moore, Licensing Program Manager (LPM) Stephenie Doub, Licensing Program Analyst (LPA) Sarah Hurt, Jacqueline Juarez, Xiao Ni, DSS Auditors, Marinela Placintar, Licensee, and Licensee Attorney Michael Levin. Since 11/5/2020, the Department has been conducting quarterly financial monitoring due to the findings of a solvency audit. The Licensee furnished documents for the 3rd quarter of 2021 which showed despite there being funds available there is still 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 2021, but that she is working on correcting this by hiring a new bookkeeper and incorporating each facility independently to avoid having to pay each facility bills one by one. 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 financial monitoring will continue six months from now with a smaller one-month audit. The licensee would provide all requested documents for only the month of September of 2022 to DSS Audits section by October 20,2022. The Licensee will submit applications to Licensing by next week to incorporate her facilities. The Licensee will also submit letters to Licensing and facility clients regarding the incorporation of the facilities by close of business on Tuesday 4/5/2022. The 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, Mar 30, 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 Administrator Bianca Marinela 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 emails to Licensee Placintar reminding of the deadlines. 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. The following deficiencies were cited per Title 22, Division 6 of the California Code of Regulations. An exit interview was conducted with Administrator Bianca Marinela 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 2, 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: The Department requested paperwork from the license by 10/15/21 and did not receive 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: Licesnsee will turn requested paperwork by 2/2/2022

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. The 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