Granny's Cottage

Type of visit: Annual/Random

Licensing Program Analyst (LPA) Sabrina Calzada arrived unannounced to conduct a required annual inspection and met with staff, Sabinel Bancu and Floarea Bancu. Administrator, Albert Bancu, arrived around 10:20 am. The facility is licensed for (6) bedridden residents and has a hospice waiver for (6). Currently, there are (3) residents on hospice. All residents to be resting at the start of the inspection. LPA and Administrator toured the interior/exterior of the facility including the common areas, (2) shared resident bedrooms, (2) private resident bedrooms, (2) resident bathrooms, kitchen, and garage/locked laundry area. LPA observed the facility to be clean, in good repair and odor-free. Bathrooms have grab bars, skid-resistant flooring, shower chair and hand-washing supplies. There are sufficient linens, towels, blankets and PPE. There is sufficient 2+day, including fresh produce, and 7+ day non-perishable food. Sharps and medications are locked near the kitchen, and toxins are locked in the laundry area. Hot water measured 115*F in the kitchen and resident bathroom. Inside temperature measured 77*F. The fire extinguisher was last serviced 6/12/26, and the smoke/monoxide alarms are functioning. Each resident room has its own exit door with an alarm. There is (1) unlocked gate, a covered gazebo, and a fountain/pond enclosed by a 3- foot fence. There are no obstructions blocking exit doors and staff know how to turn off utilities if needed. The Administrator to post a copy of House Rules. Multiple topics discussed today. LPA reviewed (2) resident files and (3) staff files. Files are organized and contain current documentation. Medications/orders were reviewed for (1) resident- no discrepancies noted and documentation is current. LPA obtained a current copy of insurance. LIC308/LIC500 due by 8/20/26. RCFE Admin Cert #7005656740 (exp 9/6/26) was renewed recently. LPA to email CCLD resources. Annual fees due by 10/25/2026. There were no deficiencies observed or citations issued. Exit interview. Copy of report provided to the Administrator.the state’s words, verbatim · CDSS document, Aug 13, 2026

Allegation investigated: Staff are overdosing resident.

Licensing Program Analyst (LPA) Sabrina Calzada arrived unannounced to deliver investigative findings to a complaint received on December 18, 2025, and met with caregiver, Floarea Bancu and shortly aftewards, the Administrator Designee, Sabia Bancu. Administrator, Albert Bancu, arrived at 11:30 am. LPA stated the reason for today's inspection. During the investigation, LPA Interviewed (2) facility staff and a family member of resident (R1) and reviewed documentation related to (R1) including, but not limited to, Physician’s Report, Medication Orders, Medication Administration Record (MAR) and the Centrally Stored Medication Record. The results are a follows: Resident (R1) moved to the facility on December 1, 2025 with a diagnosis of a Right Femur Fracture, Epilepsy, Hypotension, Aphasia, and Delirium due to a known physiological condition and required assistance with transferring, dressing, medications, toileting and was disoriented to time/place. (R1) was prescribed multiple medications, both scheduled and PRN, and moved out on December 15, 2025. ***continued on 9099C-1... Unfounded 9099C-1.. Allegation: Staff are overdosing resident. The allegation states that resident (R1) moved in with a supply of Oxycodone consisting of a bubble pack of (5) pills and a bottle of (20) pills. When (R1) moved out after (10) days or residence, there were (15) pills missing. (R1) was observed to be knocked out and asleep every day when visited almost everyday. The family member stated she moved (R1) into the facility on December 1, 2025 (1:25 pm), due to having a broken hip, and (R1) was prescribed Oxycodone 5 mg, as needed, but hadn’t taken it since November 18, 2025. The family member stated she specifically told the facility not to administer Oxycodone since (R1) moved in with their other medications, which included Tylenol 325 mg, as needed. The family member stated that when she counted (R1’s) Oxycodone on December 15, 2025, there were (15) pills less than when (R1) moved in, (R1) was only there for (10) days, excluding hospital days, and confirmed (R1) moved in with a bubble pack of (5) pills, and a bottle with (20) pills was provided the following day, December 2, 2025. Both the Administrator and Administrator Designee stated (R1’s) medications were counted when they moved in but were not sure the medications were counted when (R1) moved out. Both stated that additional Oxycodone pills were brought over after (R1) moved in. Documentation shows (5) Oxycodone pills were initially logged and then another (20) Oxycodone pills were logged on a separate page, as being administered, starting on December 11, 2025. Both administrators confirmed Oxycodone was given twice daily (morning and evening) after (R1) returned from the hospital on December 11, 2025; however, MAR documentation shows Oxycodone was given twice daily, at 8:00 am and 8:00 pm, from December 1 to December 5, 2025 and from December 11 to December 12, 2025, refused in the evening from December 13 to 14, 2025, and received it in the morning on December 15, 2025, before moving out. The MAR notes (R1) was hospitalized from December 6- 10, 2025. The Administrator indicated (R1) was receiving Oxycodone on an “as needed” basis before moving in, and it would make (R1) "sleepy and (R1) was receiving the same dosage" prior to moving to the facility. The prescription provided by the skilled nursing facility was for Oxycodone 5mg states "1 tablet every 6 hours, as needed for moderate or severe pain" with additional instructions to try at least one alternative intervention (positioning, back rubs, visualization/deep breathing exercises, and distraction) prior to administering PRN Oxycodone, and to document the number of interventions attempted. *cont on 9099C-2.. 9099C-2.. LPA reviewed medication orders for all of (R1's) medications and the MAR reflected medications were given as ordered. PRN Tylenol was also given three times daily for pain from December 1 to December 5, 2025 and from December 11 to December 14, 2025 . LPA reviewed the MAR for another resident (R2), who had moved in December 21, 2025, and observed all medications were logged and initial counts were noted, as with (R1’s) medications. The family member indicated she visited (R1) daily and at different times of the day, but the most common time was 1:00 pm, and (R1) was "always sleeping" at that time. The family member stated she asked the doctor to discontinue Oxycodone on December 14, 2025, after (R1) returned from the hospital. The MAR shows (R1) was taking multiple scheduled medications, including Depakote, twice daily, which had a side effect of drowsiness. The administrator stated he assessed (R1) in a hospital and skilled nursing setting, prior to moving in, and (R1) was very lethargic and not able to communicate well. The Administrator Designee stated during the pre-appraisal, the facility was told (R1) was not aggressive and would only “lift their hand”; however, (R1) tried to hit the family member at least once. The Administrator Designee stated he gave (R1) Oxycodone for delirium, and (R1) indicated they had pain when asked, although they were difficult to understand, commenting that if (R1) started to have non-verbal communication, such as being aggressive, he would wait (30) minutes and then try to offer the care again. The family member stated (R1) was taken to the Emergency Room on December 6, 2025 for constipation and returned to the facility on December 11, 2025. On December 13, 2025, the administrator stated that (R1) was not wanting to wake up or drink water and should be evaluated for hospice. Both administrators and the family member stated that (R1) would eat well but regularly refuse hydration. The administrator stated to LPA that this change was due to (R1's) "worsening of existing "generalized weakness"" and not due to the facility administering too much Oxycodone. The administrator stated (R1) would indicate they were experiencing pain in the morning and evening, so that is when Oxycodone was administered. Additionally the hospital discharge paperwork (December 11, 2025) gave instructions to keep Oxycodone "at minimum" (two times per day as opposed to every 6 hours) since Divalproex/Depakote was already calming (R1). The administrator stated that (R1)'s primary care provider recommended Palliative Care due to his condition being terminal, which was the main reason why (R1) often refused hydration and became constipated. LPA observed a discrepancy in what the administrators stated (R1) was administered and what the MAR documentation shows for the medication, Oxycodone 5mg. Based on the initial count (25) of the Oxycodone medication and (10) pills that were returned, (15) pills were administered over (10) days, which is significantly less than what the prescription allowed for -up to (4) pills administered daily, (1) every (6) hours. Based on information obtained, the allegation is found to be UNFOUNDED- A finding that the allegation is unfounded means that the allegation is false, could not have happened, and/or is without a reasonable basis.the state’s words, verbatim · CDSS document, Mar 10, 2026 · control 59-AS-20251218153612

Type of visit: Case Management - Incident

Licensing Program Analyst (LPA) Sabrina Calzada arrived unannounced to conduct case management inspection and met with Administrator Designee, Sabinel Bancu and caregiver, Floarea Bancu. LPA stated the reason for the inspection was to follow up on a recently submitted incident report for resident (R1). The Administrator was out of the facility at the time. There are currently (2) residents under hospice care. LPA and the Administrator Designee discussed the incident report and conditions in which (R1) was sent to the Emergency Room on 1/26/2026- dehydration, urine retention and vomiting. LPA was advised the resident returned a few hours later with a catheter and instructions for home health. The Administrator Designee indicated that (R1) is drinking much more water/cranberry juice since returning from the hospital and is more active (Physical Therapy exercises) and in communicating with their roommate more. Additionally, (R1) is receiving visits from Home Health multiple times per week, including with a nurse and social worker, and also from family. The Administrator Designee indicated (2) medications were added upon (R1) being discharged from the hospital. LPA requested a copy of the hospital discharge paperwork be provided to LPA by 1/30/2026. LPA observed (R1) resting in their room during today's inspection and was able to communicate with (R1) who indicated they are doing better since returning from the hospital. LPA toured the facility to ensure the safety of the residents in care and did not observe any health/safety risks or personal rights violation to residents. All (6) residents were resting in their rooms. It appears the facility sent (R1) out timely for medical attention when observing a change in condition. There were no deficiencies observed. There are no citations issued in this report. Exit interview. Copy of report provided.the state’s words, verbatim · CDSS document, Jan 29, 2026

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Sabrina Calzada arrived unannounced to conduct a required annual inspection and met with Administrator Designee, Sabinel Bancu and caregiver, Floarea Bancu. Administrator, Albert Bancu, arrived around 11:00 am. The facility is licensed for (6)non-ambulatory or bedridden residents and has a hospice waiver for (6). Currently, there are (2) residents on hospice. LPA and Administrator toured the interior/exterior of the facility including the common areas, (2) shared resident bedrooms, (2) private resident bedrooms, (2) resident bathrooms, (1) staff/visitor bathroom, kitchen, and garage/locked laundry area. LPA observed the facility to be clean, in good repair and odor-free. Bathrooms have grab bars, non-skid flooring, shower chair and hand-washing supplies. There are sufficient linens/towels/blankets/PPE and 2+day perishable and 7+day non-perishable food on hand. Sharps are locked in the kitchen, medications are secured nearby and toxins are locked in the laundry/garage area. The inside temperature measured 78*F. Hot water measured 120+*F in a resident bathroom and kitchen. Smoke monoxide alarms are working and the fire extinguisher was last serviced 6/27/2025. Each resident room has its own exit door with an alarm. There is (1) internet device (tablet) for resident use. There is (1) unlocked gate, a covered gazebo, and a fountain/pond enclosed by a 3- foot fence. There are no pools. LPA reviewed (2) resident files and (2) staff files. Files were organized and contained the required and current documentation. Medications and orders were reviewed for (2) residents- no discrepancies noted. Staff have current First Aid/CPR and have completed the required yearly training. Administrator certificate #7005656740 (exp 9/6/26). Updated paperwork to be added to the Plan of Operations reflecting Dementia regulation changes in 2025. Other topic discussed. LIC308/500 and updated insurance due by 9/12/25. There were no deficiencies observed. Exit interview. Copy of report provided to the Administrator.the state’s words, verbatim · CDSS document, Sep 5, 2025

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Sabrina Calzada arrived unannounced to conduct a required annual inspection and met with Albert Bancu, Administrator, and Floarea Bancu, caregiver, explaining purpose of inspection. Staff, Sabinel Bancu arrived at 2:35 pm. The facility is licensed for (6) non-ambulatory residents and has a hospice waiver for (6). Currently, there are (0) residents on hospice. LPA and Administrator toured the interior and exterior of the facility including the common areas, (2) shared resident bedrooms, (2) private resident bedrooms, (2) resident bathrooms, (1) staff/visitor bathroom, kitchen, staff room and garage/locked laundry area. LPA observed the facility to be clean, in good repair and odor-free. Vacant resident rooms have required furniture. Bathrooms have grab bars, non-skid flooring, shower chair and hygiene supplies. 20 second hand-washing instructions to be posted above all sinks. There are sufficient linens/towels/blankets/PPE and sufficient 2+day perishable and 7+day non-perishable food on hand. Sharps are locked in the kitchen, medications are secured nearby and toxins are locked in the laundry/garage area. Inside temperature measured 80*F. Fire extinguisher was last serviced 6/21/24 and smoke/monoxide alarms in working order. There is a complete first aid kit. Hot water temperature measured 118*F in the kitchen. All door alarms work throughout and screens are in good condition. There are (2) internet devices for resident use. There is (1) unlocked gate and a fountain/pond enclosed by a 3-foot fence. LPA reviewed (2) of (3) staff files and found them to be organized, current and contain the required documentation. Medications were checked for (2) residents- orders match medications being given and documentation is current. All staff (3) have current First Aid/CPR and have completed the required yearly training. Administrator certificate #6019037740-exp 9/6/24 is pending renewal. Other topics discussed. An updated copy of liability insurance was obtained. LIC308 and LIC500 to be provided by 9/19/24. There were no deficiencies observed. Exit interview. Copy of report provided to the Administrator.the state’s words, verbatim · CDSS document, Sep 12, 2024

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Sabrina Calzada arrived unannounced to conduct a required annual inspection. LPA met with caregivers, Floarea Bancu and Sabinel Bancu, and explained purpose of inspection. Albert Bancu, Administrator, arrived at 11:30 am.The facility is currently licensed for (6) non-ambulatory residents and has a hospice waiver for (6). Currently, there are (4) residents on hospice. LPA and Administrator toured the interior and exterior of the facility including the common areas, (2) shared resident bedrooms, (2) private resident bedrooms, (2) resident bathrooms, (1) staff/visitor bathroom, kitchen, staff room and garage/locked laundry area. LPA observed the facility to be clean, in good repair and odor-free. All bathrooms have the necessary grab bars, non-skid flooring, paper towels and hand-washing posters. LPA observed sufficient 2+day perishable and 7+day non-perishable supply of food, including fresh produce. Sharps are locked in the kitchen, medications are secured nearby and toxins are locked in the laundry/garage area. Inside temperature measured 77*F. Fire extinguisher was last serviced 6/19/23 and smoke/monoxide alarms in working order. Hot water temperature measured 118*F in the kitchen and 120*F in a resident bathroom. First Aid kit is complete. There are sufficient paper/incontinent products, PPE and linens/blankets . All required postings are posted. All doors have exit alarms and there is (1) unlocked gate in the backyard. There is covered patio seating. LPA reviewed and approved the Infection Control Plan (LIC9282) updated in May 2023. LPA reviewed (3) staff files- all staff have current First Aid/CPR training and have completed the required annual training. LPA reviewed (2) resident files and found them to be organized and contain current paperwork. Medication orders were compared with medications being administered for (1) resident, and there were no discrepancies found. All medication is being documented correctly on the Medication Administration Record (MAR) and the LIC622. LPA requested an updated copy of LIC308 and LIC500 be provided to the Department by 10/16/23. There were no deficiencies observed.Exit interview. Copy of report given to Administrator.the state’s words, verbatim · CDSS document, Oct 9, 2023

Type of visit: Post Licensing

Licensing Program Analyst (LPA) Sabrina Calzada arrived unannounced to conduct a required annual inspection. LPA met with caregivers, and explained purpose of inspection. Albert Bancu, Administrator, arrived at approximately 11:30 am. LPA is conducting an annual inspection today but this report is being generated to clear the Post-Licensing inspection in the system. There are no citations issued on this report. Exit interview. Copy of report provided to the Administrator.the state’s words, verbatim · CDSS document, Oct 9, 2023