Hovley Care

Allegation investigated: Staff speaks to resident in an inappropriate manner. Staff did not accord resident personal privacy with visitors.

On 08/31/2023, Licensing Program Analyst (LPA) Chinwe Nwogene conducted an unannounced visit to investigate the above allegations. LPA met with Licensee, Svetlana Calamaro who was informed of the purpose of the visit. During the visit, staff and resident were interviewed. Regarding the allegation “Staff speaks to resident in an inappropriate manner” it was alleged staff yelled at resident and was aggressively speaking to resident. Resident was interviewed, the interview revealed staff yells at resident. Licensee was interviewed who acknowledged speaking to resident and resident’s daughter in a raised voice because licensee heard the facility caregiver names mentioned during resident and resident daughter's conversation with a Kaiser Nurse (Substantiated). Regarding the allegation “Staff did not accord resident personal privacy with visitors” it was alleged staff was ear dropping on resident and resident daughter's conversation with nurse. Staff was interviewed who denied was ear dropping on residents’ conversation. Staff stated resident’s room door was open and staff could hear the conversation while sitting on the couch in the Livingroom. Staff heard caregiver names mentioned in the conversation, so staff went into resident’s room to explain. The nurse and resident’s daughter were interviewed who acknowledged resident’s bedroom door was open and wasn’t too far from the Livingroom where staff was sitting, and staff could have heard the conversation. However, staff barged into resident’s bedroom without knocking, started yelling, was so loud and banging on the table. Based on interviews, the above allegation is found to be substantiated. California Code of Regulations (Title 22, Division & Chapter number 6) is being cited on the attached LIC 9099D). An exit interview was conducted, and a copy of this report was reviewed with and provided to Jennifer Carrillo. Substantiatedthe state’s words, verbatim · CDSS document, Aug 31, 2023 · control 18-AS-20230828120114

From the deficiency page — Deficiency type: Type B · Section cited: CCR 80072(a)(3) · Plan of correction due date: Feb 12, 2024

Personal Rights; (a) Except .... each client shall have personal rights which include, but are not limited to, the following: (3) To be free from corporal or unusual punishment, infliction of pain, humiliation, intimidation, ridicule, coercion, threat, mental abuse, or other actions of a punitive nature.... This requirement is not met based as evidence by interview. The licensee did not comply by yelling at resident which poses a potential health, safety, or personal rights risk to persons in care.the state’s words, verbatim · CDSS document, Aug 31, 2023

Plan of correction: Licensee stated moving forward resident will be spoken to in a respectful tone and a written statement of understanding of the regulation cited will be provided to LPA by the POC 2/12/2024.

From the deficiency page — Deficiency type: Type B · Section cited: CCR 87468.2(a)(1) · Plan of correction due date: Feb 12, 2024

Personal Rights; To have a reasonable level of personal privacy in accommodations, medical treatment, personal care and assistance, visits, communications, telephone conversations, use of the Internet, and meetings of resident and family groups This requirement is not met based as evidence by interview. The licensee did not comply by barging into resident’s bedroom without knocking and not accord resident personal privacy which poses a potential health, safety, or personal rights risk to persons in carethe state’s words, verbatim · CDSS document, Aug 31, 2023

Plan of correction: Licensee stated a written statement of understanding of the regulation cited will be provided to LPA by the POC 2/12/2024.

Allegation investigated: Licensee refusing to provide medication to resident. Licensee not keeping facility adequate temperature for residents in care.

On 08/08/2023, Licensing Program Analyst (LPA) Chinwe Nwogene conducted an unannounced visit to investigate the above allegation(s). LPA met with caregiver, Alicia Sical who was informed of the purpose of the visit. At the time of visit, LPA interviewed staff and resident and conducted facility inspection. Regarding the allegation “Licensee refusing to provide medication to resident”, It was alleged Licensee refused to give resident medication unless resident’s responsible party provides medical POA documents. LPA interviewed Licensee who denied refusing to give resident medications. Licensee stated resident’s medications are administered to resident daily. Licensee stated resident is constantly requesting for PRN medications even when not needed and requesting medications be stored in resident’s room. Licensee stated the medical POA documents was requested because staff needs someone to communicate with about resident’s medical needs. LPA interviewed resident who denied Licensee refused to provide medication to resident. Interview with resident revealed resident receives medication daily. UNSUBSTANTIATED. Continue on LIC9099-C Unsubstantiated Continued from LIC9099. Regarding the allegation “Licensee not keeping facility adequate temperature for residents in care”, it was alleged resident’s room was 87 degrees Fahrenheit. Staff was interviewed who stated two weeks ago the air conditioner was broken. Staff stated resident was moved to the living room where it was cooler. Staff stated the landlord, and the air conditioner repairer was immediately called and the air conditioner was fixed in two #2 hours. LPA interviewed resident who stated the temperature is okay. LPA inspected facility temperature including resident’s room and observed facility to be cool at 75, 76, 80 degrees Fahrenheit. LPA observed resident room had air conditioner and fan. UNSUBSTANTIATED. Based on interviews with staff, resident, and facility inspection there is not enough evidence to support the above allegation. Although the allegations may have happened or are valid, there is not a preponderance of evidence to prove the alleged violations did or did not occur, therefore the allegations are unsubstantiated at this time. An exit interview was conducted, and a copy of this report was reviewed with and provided to Alicia Sical.the state’s words, verbatim · CDSS document, Aug 8, 2023 · control 18-AS-20230802155828

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Kathleen Banrasavong arrived unannounced to conduct an annual inspection. Upon arrival LPA was greeted by facility staff and granted entry. LPA began inspection with introduction and visit purpose. Upon arrival LPA learned that four (4) clients reside at this facility and there are currently (1) caregiver present. Facility caregiver, Alicia Sical-Casteneda (S1) gave the facility tour. LPA later observed one staff (S2) that came into the facility but was not associated through Guardian. The staff had a fingerprint clearance through DOJ in the staff’s file. There is not an Infection Control Plan on file. LPA advised facility that they need to have an infection control plan on file. Client Records-Incident Reports/Clients Rights-Information/Dental- LPA began review of client records. Four (4) records were reviewed. LPA reviewed for identification and emergency information, admission agreement, medical assessment and TB test results, needs and service plans, placement, functional assessment, centrally stored medication/destruction records, safeguard for personal property/valuables, and personal rights notification. There was one resident (R1) who has dementia that did not have an updated Physician’s report. LPA advised Alicia Sical-Casteneda that they needed to update that for the facility files and record keeping. Personnel Records/Training/and Staffing- LPAs began review of employee records- Two (2) records were reviewed. LPA reviewed employee records for first aid certification, criminal record clearance or an exemption, health screening and TB test results, employee rights, training verification, and current administrator certification. The administrator certification is not current and annual fees are not paid. LPA informed the facility representative and administrator over the phone. LPA gave PIN to caregiver to provided to licensee. (Continued on LIC809C) (Continuation from LIC809) Food Service- Food prep areas are clean and organized. Food supply meets the requirement of one (1) week supply of nonperishable and two (2) day supply of perishables. Emergency food and water supply is present. There is a locked location for chemicals and sharps in the kitchen. Physical Plant and Safety of Environment/Operational Requirements- LPA toured the facility inside and outside. LPA observed the facility to be clean and in good repair. The home is maintained at a comfortable temperature for the clients. Lighting is sufficient for safety and comfort. Water temperature measured 106.0 degrees F. Laundry facilities and a locked room is present for storing laundry soap and other chemicals. All outdoor and indoor passageways are free of obstruction. Emergency lighting is available. There is a telephone working at this location. The LIC 610, emergency disaster plan is maintained. There are no firearms at this home. There is a pool with a 5 foot locked gate around the perimeter. The fireplace is not operable and secured. Medications- are centrally stored. There is a locked cabinet allocated for medication storage. Centrally stored medication and destruction logs are maintained separately. Medications reviewed appear to have been dispensed accurately. LPA made observation throughout the inspection process to assess if the facility remains in conformity with the State Fire Marshall regulations. 5 smoke detectors were tested and found to be operational. There were two (2) fire extinguisher last was recharged, 10/15/2021. LPA advised the facility representative that the fire extinguisher was expired and for best practice they should get the fire extinguishers replaced. The facility caregiver states that they don’t do emergency disaster/fire drills. LPA advised facility to perform disaster/fire drills. (Continued on LIC809C) (Continuation from LIC809) Based on the information received during this visit today in the areas reviewed, there are 1 type A deficiency 87412(d) that will be assessed with an civil penalty that are being cited per Title 22, Division 6 of The California Code of Regulations. Upon the facility tour, LPA learned that resident Mary Firmin had passed away April 12, 2023. Upon looking at the facility files and submitted SIRS, the facility has not sent in any SIRS since 2018. There was no death report for Mary Firmin. LPA and facility representative collaborated and agreed to have the 2 fire extinguisher replaced or recharged, an infection control plan in place, CPR and first aid certification current. Licensee states that carbon monoxide will bought and in the facility in 24 hours. The facility has agreed to have a plan of corrections emailed to the LPA by June 8, 2023. This LIC 809 was reviewed with and a copy will be emailed and mailed to the facility representative and a confirmation of receipt will be requested.the state’s words, verbatim · CDSS document, Jun 1, 2023

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA), Chinwe Nwogene made an unannounced visit to the facility to conduct an annual inspection focused on infection control. LPA was greeted and granted entry by Administrator, Svetlana Calamaro who was informed of the purpose of the visit. At the time of visit there was 1 staff and 4 residents present. The facility currently has zero positive or suspected Covid-19 cases. During today's visit, LPA toured the facility and made observations regarding the infection control measures that the facility has implemented. LPA observed Covid-19 postings posted throughout the facility. The facility has an adequate amount of hand hygiene supplies (soap, and hand sanitizer) in all restrooms. LPA observed an adequately secured pool within the premises. LPA was informed that no weapons or ammunition is maintained at the home. LPA informed Svetlana about the annual fees due. Svetlana agreed to pay annual fees online. LPA gave Svetlana PIN number. The facility has a plan in place to monitor residents regularly for any changes in condition, which includes daily temperature checks. The Facility will contact the resident's physician should there be any event of COVID-19 related illnesses. The facility has a designated infection control lead. The facility also cleans and disinfects the highly touched surfaces during each shift, and as needed. LPA observed PPE supplies. No deficiencies noted at the time of visit. An exit interview was conducted, and a copy of this report was reviewed and provided to Svetlana Calamaro.the state’s words, verbatim · CDSS document, Jun 29, 2022

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.

Allegation investigated: Facility is in disrepair Fire detectors are in disrepair

Licensing Program Analyst (LPA) Crystal Colvin arrived at the facility unannounced for the purpose of initiating an investigation for a complaint with the above allegation(s). LPA Colvin was granted entrance and met with caregiver Carmita Smith, who assisted LPA Colvin during today's inspection. Administrator Svetlana Calamaro was not able to be present during today's inspection but was contacted via telephone and informed of the purpose of today's visit. Below is a summary of today's findings: Regarding allegation "Facility is in disrepair": LPA Colvin inspected various appliances and interviewed staff and Administrator Calamaro regarding the allegation. LPA Colvin observed that the kitchen microwave was only partially operational, as the "start" button was not working, so staff must press "micro express" which starts the cooking process with 30 seconds of cook time. Due to this, caregivers must press the "micro express" button multiple times or in succession after each cooking period. LPA Colvin additionally observed that the pipes below the kitchen sink are leaking, as evidenced by buckets/containers filled with water placed underneath the sink. Substantiated The Administrator stated that they had a meeting with the landlord the previous day and is working on getting items fixed or replaced, including the garbage disposal. Based on observations and interviews, the allegation "Facility is in disrepair" is SUBSTANTIATED. Regarding allegation "Fire detectors are in disrepair": LPA Colvin toured the facility and tested all smoke detectors in common areas and resident bedrooms. LPA Colvin observed that all smoke detectors tested were operational except for the smoke detector in the hallway separating the two resident bedrooms on the right-hand side of the facility. When LPA Colvin tested this smoke detector, LPA Colvin hear a quiet beep, but did not observe the expected loud noise which would alert occupants to a potential fire. LPA Colvin spoke on the phone with the Administrator, who confirmed that they had heard the same small beep the previous day when they tested the alarms, as some of the smoke alarms had just been replaced. Additionally, whiel LPA Colvin was typing this report, LPA Colvin could hear the occasional beeping that LPA Colvin identified as coming from the direction of the non-operable smoke detector. This beeping is commonly observed when a smoke detector has low batteries. Therefore, based on observations and interviews, the allegation "Fire detectors are in disrepair" is SUBSTANTIATED. A finding that the complaint is SUBSTANTIATED means that the allegation(s) is valid because the preponderance of the evidence standard has been met. Fire clearance and fire safety deficiencies are categorized in Title 22 Regulations and Health and Safety Code as immediate hazards which result in an immediate civil penalty in the amount of $500. Therefore, based on the inoperable smoke detector, LPA Colvin is citing a one time $500 civil penalty. An exit interview was conducted where this report and appeal rights were discussed. A copy of this report, LIC9099D, LIC401IM, and appeal rights was provided to caregiver Carmita Smith during the exit interview. All reports additionally will be emailed to the Administrator as well. Regarding allegation "Facility does not have a carbon monoxide detector": LPA Colvin toured the facility and did not observe any individual carbon monoxide detectors in the facility. LPA Colvin interviewed the Administrator who informed LPA Colvin that the newly purchased/installed smoke detectors have carbon monoxide detectors in them as well. LPA Colvin confirmed seeing the new smoke alarms, and LPA Colvin has the knowledge from inspecting facilities that the new smoke detectors come with carbon monoxide detectors incorporated in them. Therefore, based on observations and interviews, the allegation "Facility does not have a carbon monoxide detector" is UNFOUNDED. his agency has investigated the complaint alleging facility premises are not properly secured and facility does not have a carbon monoxide detector. We have found that the complaint was UNFOUNDED, meaning that the allegation was false, could not have happened and/or is without a reasonable basis. We have therefore dismissed the complaint. An exit interview was conducted where this report was discussed. A copy of all reports and forms were provided to caregiver Carmita Smith during the exit interview. All reports additionally will be emailed to the Administrator as well.the state’s words, verbatim · CDSS document, Aug 20, 2021 · control 18-AS-20210818093958

From the deficiency page — Deficiency type: Type A · Section cited: CCR 1569.49(c)(2)(A) · Plan of correction due date: Aug 23, 2021

Civil penalties...for deficiencies: (c) The department shall assess an immediate civil penalty of five hundred dollars ($500)...for any of the following serious violations: (2) (A) Fire clearance violations, including, but not limited to...inoperable smoke alarms... This requirement was not met as evidenced by: Based on observations and interviews, the Licensee did not comply with the above regulation with 1 of 6 smoke detectors. LPA Colvin observed the smoke detector in the hallway in-between the resident bedrooms on the right of the facility to be inoperable. This is an immediate safety hazard for all residents.the state’s words, verbatim · CDSS document, Aug 20, 2021

Plan of correction: Licensee agrees to have the smoke detector fixed, replaced, or have the batteries changed, whichever is required to make it operational. Licensee may self-certify to LPA Colvin that the smoke detector is operational. Self-certification due to LPA Colvun by 8/23/21.

From the deficiency page — Deficiency type: Type B · Section cited: CCR 87303(a) · Plan of correction due date: Aug 31, 2021

Maintenance and Operation: (a) The facility shall be clean, safe, sanitary and in good repair at all times. Maintenance shall include provision of maintenance services and procedures for the safety and well-being of residents, employees and visitors. This requirement was not met as evidenced by: Based on observation and interviews, the Licensee did not comply with the above regulation with two facility appliances/fixtures. LPA Colvin observed the kitchen microwave and kitchen sink to be in disrepair (start button on microwave and leaking sink pipes). This is a potential personal rights violation.the state’s words, verbatim · CDSS document, Aug 20, 2021

Plan of correction: Licensee agrees to have the microwave and kitchen sink pipes either repaired or replaced. Licensee may self-certify to LPA Colvin that the appliances/fixtures have been corrected. Self-certification due to LPA Colvun by 8/31/21.

The state marks this report as 6 pages; the online copy we transcribed has 5. You can request the full file from the county licensing office.

Type of visit: Case Management - Deficiencies

Licensing Program Analyst (LPA) Crystal Colvin arrived at the facility unannounced for the purpose of investigating a complaint (#18-AS-20210818093958). During LPA Colvin's inspection, LPA Colvin observed additional items that needed to be addressed with the Administrator. Below is a summary of what was observed: During LPA Colvin's inspection today, LPA Colvin was unable to access staff files, as they were not on site at the facility. Facilities are required to have all files available to Licensing to inspect at all times. Deficiency cited. Additionally, during LPA Colvin's review of resident files, LPA Colvin observed that one resident (R1) is classified as bedridden based on their Physician's Report from 2/25/21. The facility does not currently have a fire clearance for bedridden residents and does not have a program plan for caring for bedridden residents as well. Usually, a violation of the fire clearance would result in an immediate civil penalty of $500, however, LPA Colvin was informed by the Administrator that R1 has been served with a 30-day eviction notice. Health and Safety code 1569.49(c)(2)(A)(ii) states that if the eviction process has been initiated, the facility shall not be cited civil penalties. LPA Colvin will still be citing a deficiency and the facility shall either have R1 relocated or apply for bedridden clearance through Community Care Licensing. Deficiency cited. An exit interview was conducted where this report and appeal rights were discussed. A copy of this report, LIC809D, and appeal rights was provided to caregiver Carmita Smith during the exit interview. All reports additionally will be emailed to the Administrator as well.the state’s words, verbatim · CDSS document, Aug 20, 2021

From the deficiency page — Deficiency type: Type A · Section cited: HSC 1569.72(a)(2) · Plan of correction due date: Aug 23, 2021

Residents requiring skilled nursing or intermediate care; bedridden residents: (a) ...no resident shall be admitted or retained in a residential care facility for the elderly if any of the following apply: (2) The resident is bedridden...This requirement was not met as evidenced by: Based on record review, the Licensee did not comply with the above regulation with 1 of 4 residents (R1). LPA Colvin observed in R1's Phsycian's Report dated 2/25/21 that R1 is bedridden. The facility is licensed and has fire clearance for non-ambulatory only. This is an immediate safety risk for R1.the state’s words, verbatim · CDSS document, Aug 20, 2021

Plan of correction: Licensee agrees to either relocate R1, apply for bedridden clearance. Licensee shall provide LPA Colvin with etiher the application for bedridden clearance, or proof of working on relocating R1 by Plan of Correction date of 8/23/21.

From the deficiency page — Deficiency type: Type B · Section cited: CCR87412(g) · Plan of correction due date: Aug 31, 2021

Personnel Records: (g) All personnel records shall be maintained at the facility and shall be available to the licensing agency for review. This requirement was not met as evidenced by: Based on observations and interviews, the Licensee did not comply with the above regulation with all staff files. LPA Colvin was unable to review staff files as they were not on site and not provided to LPA Colvin during the inspection. This is a potential safety and personal rights violation to all residents.the state’s words, verbatim · CDSS document, Aug 20, 2021

Plan of correction: Licensee agrees to supply LPA Colvin with the background clearance inforamtion for all current staff as well as staff schedule by 8/27/21. Licensee to additionally either return all files to the facility or implement plan for Licensing to access files. Licensee to provide LPA Colvin with update by 8/31/21.