Green Gables Care Home VII

Allegation investigated: Staff confined resident to their room while in care. Staff did not ensure that resident's hygiene needs were met while in care

On 10/20/2023 Licensing Program Analysts (LPA's) M. Garza and M. Flores arrived at facility for an unannounced complaint visit. LPA met with Direct Care Staff, Joseph and Gamare Whigan. Licensee, Lorik Sheakalee was contacted and stated they were unavailable to come to the facility. LPA was informed Assistant, Mario Ramos would arrive some time later. LPA's completed a tour of the facility inside and out and a health and safety check on residents in care. Residents observed in common areas and in rooms. During visit LPA's completed interviews with staff and resident(s). LPA's reviewed documentation (physicians reports, needs and assessments, pre-placement appraisal). Interviews with RP and S1 indicated that R1 had hygeine needs were not met. Interview conducted with medical profession indicated that R1 was being confined to their room. The preponderance of evidence standard has been met per Title 22. The allegations listed above are SUBSTANTIATED. Deficiency cited on 9099D. Exit interview conducted with Licensee, Lorik Sheakalee and Assistant, Mario. A copy of this report and appeal rights given. Substantiatedthe state’s words, verbatim · CDSS document, Oct 20, 2023 · control 24-AS-20231011112134

From the deficiency page — Deficiency type: Type B · Section cited: CCR 87411(a) · Plan of correction due date: Oct 31, 2023

87411 Personnel Requirements-General (a) Facility personnel shall at all times be sufficient in numbers, and competent to provide the services necessary to meet resident needs…Additional staff shall be employed as necessary to perform office work, cooking, house cleaning, laundering, and maintenance of buildings, equipment and grounds. The licensing agency may require any facility to provide additional staff whenever it determines through documentation that the needs of the particular residents, the extent of services provided, or the physical arrangements of the facility require such additional staff for the provision of adequate services. This requirement was not met as evidence by: LPA interviews of RP, staff and residents. Interviews indicated that resident was confined to their room and hygeine needs were not being met.the state’s words, verbatim · CDSS document, Oct 20, 2023

Plan of correction: Licensee to provide in-service training to all staff. In-service sign in sheet and training material to be provided to CCL by POC date. Licensee stated they will be generating a log and provide to CCL.

Type of visit: Case Management - Deficiencies

On 10/20/23, Licensing Program Analyst (LPA’s) M. Flores and M. Garza made an unannounced case management visit. LPAs were granted entry to the facility by care staff, Joseph and Gamaree Whigan. Licensee, Lorik Sheakalee, was contacted by and stated she was unable to come to the facility. LPA was informed that Assistant, Mario Ramos arrived at the facility minutes later. LPAs completed a tour of the facility inside and out and health and safety check on residents in care. Residents observed in common areas and in rooms. During the facility tour the following was observed by LPAs: 1. Lock installed on top of the entrance door. 2. Cleaning supplies unlocked in the bathroom. 3. Chemicals unlocked in the laundry room. 4. Door alarm to the sliding door turned off. 5. Side walkway was accessible to residents and observed to be unleveled and missing paver rocks. Technical Violations provided for the above issues. Exit interview completed with Assistant, Mario Ramos. A copy of this report provided to Mario Ramos.the state’s words, verbatim · CDSS document, Oct 20, 2023

Type of visit: Required - 1 Year

On 08/30/2022, Licensing Program Analyst (LPA) M. Yang arrived unannounced to conduct an Annual Inspection - Infection Control. LPA introduced self, stated the purpose of the visit, and requested to meet with the Administrator. LPA was met by Caregiver Joseph Whigan. LPA toured facility with caregiver. Administrator Marsha Sheakalee was called and unable to attend meeting. Administrator authorized Assistant Mario “Daniel” Ramos to received and sign report. Assistant arrived shortly during tour. All five residents were present during the inspection. Upon entry facility staff was observed with face mask. Visitor log-in/temperature check was observed upon entry. Hand sanitizer was readily available to residents and visitors. Facility has one entrance/exit point. Facility appeared cleaned with no obstruction or fire clearance issues. Social distancing is maintained in the common and dining areas. Social distancing and cough etiquette postings observed. LPA observed fire extinguisher served date: 03/15/22. LPA checked residents’ locked medications. LPA observed small amount of PPE supplies in facility. 30 days PPE supplies storage in a central location. Food supply was checked and appeared to be an adequate supply. Cleaning supplies were stored and locked in garage. All resident’s room toured and observed to be adequately furnished and lit. LPA observed five single occupant rooms and one vacant bedroom. All bathrooms are observed with securely fastened grab bars and non-skid mat. All bathrooms observed trash bin with lid. Hand washing posting observed by bathroom sinks.The exterior tour was conducted. Side gate was self-closing and self-latching. Staff records were reviewed for good health and infection control training. Three of five resident records reviewed to have updated emergency contact information. No deficiencies issued during this inspection. Exit Interview conducted. The following documents are requested and submitted to Fresno CCL by: 9/7/22. The following updated forms were requested: Lic 308, Lic 309, Lic 500, Lic 610E, Lic 9282, Administrator Certificate and current liability insurance. A copy of this report was provided to Assistant.the state’s words, verbatim · CDSS document, Aug 30, 2022

Type of visit: Required - 1 Year

On 09/03/2021, Licensing Program Analysts (LPAs) M. Yang and K. Brown arrived unannounced to conduct an Annual Inspection - Infection Control. LPAs introduced self, stated the purpose of the visit, and requested to meet with the Administrator. LPA was met by Caregiver Nelia Rosete. Robert Sheakalee, Designee Representative was called and arrived later. All six residents were present during the inspection. LPA conducted a complete tour of the facility with Administrator and caregiver. The facility was observed without any fire clearance issues or obstruction. Common areas had furniture and was lit. The resident’s rooms were toured and were observed with required furniture. LPAs toured resident bedrooms and bathrooms. Bedrooms were adequately furnished and lit. Bathrooms were clean and had secure grab bars and nonskid mats in showers. Cleaning supplies and chemicals were observed in the locked garage. LPAs did not observed 30-day PPE. Medications were kept in a locked cabinet. First Aid Kit checked to have the required items. LPAs observed a 14- day supply of nonperishable food and a 2-day supply of perishable food which were stored properly. LPAs discussed and reviewed LIC 808 including Infection control procedures to be implemented: Daily symptoms screenings (for staff, persons in care and visitors), testing, visitation, quarantine/isolation procedures, emergency staffing plan, PPE storage, use and training, as well as daily infection control procedures. Completed LIC 808 Mitigation Plan to be submitted to CCL by 09/10/21 No deficiencies issued during this inspection. Exit Interview conducted. The following forms were requested: LIC 308 Designation of Facility Responsibility, LIC 500 Personnel Report, LIC 610E Emergency Disaster Plan For Residential Care Facilities For The Elderly, LIC 9020 Register of Facility Clients/Residents, updated Liability Insurance, LIC 309 Administrative Organization, Administrator Certificate, LIC 309 Administrative Organization, current Liability Insurance, copy of Administrator Certificate. Please submit the above forms/information to Fresno CCL by: 09/7/21.the state’s words, verbatim · CDSS document, Sep 3, 2021

The state marks this report as 6 pages; the online copy we transcribed has 1. You can request the full file from the county licensing office.