Keen Home Long Beach

Type of visit: Required - 1 Year

On 12/05/25, Licensing Program Analyst (LPA) Villegas conducted an unannounced annual required visit using the CARE Inspection Tool. LPA met with Administrator Latoya Johnson as the purpose of the visit was explained. The facility is licensed to serve (6) bedridden residents ages 60 and over, and has an approved hospice waiver for (6). Annual Fees are current. Liability insurance is active (Exp: 08/06/2026). This facility is located in a gated community and it consists of (6) resident bedrooms, (2) full bathrooms, (1) half bathroom, kitchen, living room/TV room, receiving room, dining area, a Pantry, shaded patio, and a garage. There are no bodies of water or firearms on the premises. Resident bedrooms were checked, mattresses and box springs were in good condition, adequate lighting, plenty of dresser and closet space was observed. Bathroom toilets and water faucets worked properly, shower was free of mold/mildew, and there are sufficient toiletries accessible to residents. The kitchen was inspected and there is sufficient perishable and non-perishable food available. The water temperature properly measured between 105-120 F.. Storage areas for personal hygiene, cleaning supplies, and toxins were stored and not accessible to residents. The last facility fire drill was on 10/21/25. Operable smoke detectors/carbon monoxide in bedrooms and hallways were observed. (2) fire extinguishers are in the kitchen and hallway. First aid kits were observed throughout the facility, checked and fully stocked. LPA conducted a records review of 3 staff records, 4 resident records, and 4 medication administration records, no discrepancies observed. Medications were centrally stored and properly locked. Exit interview conducted, and a copy of this report was provided.the state’s words, verbatim · CDSS document, Dec 5, 2025

Type of visit: Required - 1 Year

On October 16, 2024, Licensing Program Analyst (LPA) Deborah Lee conducted an unannounced required annual visit using the CARE Inspection Tools. LPA met with Aurora Ortiz, Lead Staff and explained the purpose of this visit. Subsequently Administrator Ginny Dutile arrived and assisted with the visit. The facility is licensed to operate for (6) Bedridden elderly residents ages 60 and above and has an approved hospice waiver for (6); There are currently 6 residents in care--none of which are currently bedridden. Structure This facility consists of six (6) resident bedrooms, three (3) full bathrooms and 1/2, kitchen, living room/TV room, receiving room, dining area, shaded patio, and a garage which serves as an office/storage space. Operable smoke detectors/carbon monoxide throughout facility were observed. Two fire extinguishers last serviced on 02/05/2024 are in the kitchen and hallway. The last facility fire drill was on 08/22/2024 Physical Plant LPA and Ginny Dutile toured the facility inside and outside. LPA observed there were no bodies of water on the premises. All rooms were inspected. Beds and bedding supplies were in good condition, adequate lighting was provided, and storage for the resident's personal belongings was observed. LPA observed that facility had required postings: ombudsman poster, see something say something poster, clients rights, infectious disease postings, activities calendar and facility sketch. Page 1 of 3 Bedrooms LPA inspected all six (6) bedrooms. All bedrooms were observed to have the required furniture including beds, dressers, nightstands with lamps, chairs, and ample storage space for personal belongings. All bedrooms were observed to be clean, in good repair, and have ample lighting. Bathrooms LPA inspected the facility bathrooms. In the resident’s bathroom the toilet, faucets, and shower were fully operational. All safety handrails were securely fastened. LPA observed the showers to be clean and free of mold or mildew. The shower had a nonskid material in bottom and shower chair. LPA observed area where residents toiletries are kept. The water temperature measured 112-degrees Fahrenheit. The toilet and faucets are operational. Both bathrooms were observed to be clean, in good repair and within Title 22 regulations. Linens & Hygiene LPA observed all beds to have the required linens including mattress cover, fitted sheets, blanket, comforter, and pillow. LPA observed an ample supply of linens, towels, and blankets in the hall closets. Kitchen/Laundry Room LPA inspected the kitchen and observed all appliances to be in good working repair, including stove/oven, microwave, dishwasher, washer, dryer, refrigerator, and additional freezer. LPA observed an ample supply of cutleries, pots, pans, and bowls to be in good repair. LPA observed knives and additional sharps to be secured in locked cabinet in the kitchen and are inaccessible to residents. LPA observed a 3-day supply of perishable foods and a 7-day supply of nonperishable foods. Cleaning products and toxins were secured in closet that is inaccessible to clients. page 2 of 3 Common Rooms In the living room, LPA observed 2 recliners 2 chairs sofa mounted TV. In the dining room, LPA observed a six seated dinning table and large kitchen counter separating dinning area from kitchen. There is a "den" area with mounted TV and adequate seating: 4 recliners. Medications LPA observed all centrally stored medications in their original packaging and are secured in a locked closet that is inaccessible to Residents in care. Files LPA reviewed (6) resident files and found they contained all the necessary documentation. LPA reviewed four (4) staff files and found they contained the required documentation, certification, and training. Liability Insurance expires on 8/6/2025. Infection Control During the visit, LPA observed the facility’s infection control practices. LPA observed a sanitizing station at the facility entrance. PPE supplies are readily available to staff, and an additional 30-day supply of PPE was observed. Sufficient paper towels, cleaning, and disinfecting supplies were observed and stored in garage area. There were no deficiencies cited during today’s visit. An exit interview was conducted with Ginny Dutile, Administrator. A copy of this report was given to Administrator. page 3 of 3 page 3 of 3the state’s words, verbatim · CDSS document, Oct 16, 2024

Allegation investigated: Staff did not provide proper food service to resident in care Staff did not follow proper refund requirements Staff threatened to destroy resident's medication Staff overcharged resident/resident's representative

On 06/13/2024 Licensing Program Analyst (LPA) Mario Leon conducted a subsequent complaint visit to deliver findings for the above-mentioned allegations. LPA was met by LaToya Johnson, Administrator (S2) and the purpose of the visit was explained. The investigation consisted of the following: On 06/13/2024 LPA arrived to deliver findings for the above-mentioned allegations. On 05/24/2024 LPA requested feeding schedule and information regarding special diet(s) for residents present during that period. On 04/09/2024 LPA interviewed 4 residents. On 03/18/2024 LPA requested training records for all staff who were present during resident one's (R1) stay and a copy of R1’s hospice care plan. LPA also interviewed two (2) staff. On 06/28/2023 LPA conducted an unannounced complaint visit to the above-mentioned facility. LPA was met by Aurora Ortiz, Team Lead (S3), and later by Adrien Herbas, Administrator (S1), and the purpose of the visit was explained. Report continues, see LIC9099C. Unsubstantiated LPA requested resident roster, staff roster, hospice care plans, physician reports, pre-placement appraisals, appraisals, identification and emergency contacts and other service documents which related to rental fees and back pay. A plant inspection was conducted and above-mentioned records were reviewed. The investigation revealed the following: Regarding the allegation “Staff did not provide proper food service to resident in care”, It has been alleged that staff were uninformed regarding the feeding procedures for R1 during the weekend of 05/26/2023 through 05/29/2023. Record reviews revealed that on 05/27/2023 R1’s hospice team ordered “NPO” (Nothing By Mouth), which is shorthand for a period of time in which one may not eat or drink anything, aside from comfort medication. Interviews held on 06/28/2023 and 03/18/2024 revealed that four (4) out of 4 staff and three (3) out of four (4) residents have denied the allegation had taken place, while one (1) resident was unable to provide a verbal or visual response. Based on record reviews and interviews conducted, the preponderance of evidence standard has not been met. Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove that the alleged violation occurred. Therefore, the above allegation has been Unsubstantiated. Regarding the allegation “Staff did not follow proper refund requirements”, it has been alleged that staff did not provide any refund(s) for the dates as follows: 06/02/2023 through 06/05/2023. Record reviews revealed that the balance of $11,916.68 was paid to a family member of R1, posted on 06/12/2023. Record reviews also indicated that "unused rent moneys will be returned 15 days after room is vacated of all belongings, clothing and furnishings." and that R1's hospice items were removed from the facility on 06/04/2023. Interviews held on 06/28/2023, 03/18/2024 and 04/09/2024 revealed that 4 out of 4 staff and three (3) out of four (4) residents have denied the allegation had taken place, while one (1) resident was unable to provide a verbal or visual response. Based on record reviews and interviews conducted, the preponderance of evidence standard has not been met. Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove that the alleged violation occurred. Therefore, the above allegation has been Unsubstantiated. Report continues, see LIC9099C. Regarding the allegation “Staff threatened to destroy resident's medication”, it has been alleged that staff were uninformed regarding the delivery of comfort medications to R1, while R1 was under the above-mentioned facility’s care. Record reviews revealed that during a visit on 05/30/2023, by a skilled nurse (SN), visit notes were logged as follows: “SN reinforced teachings with caregiver, S3, on pain management including use of morphine and ativan as needed. Caregiver, S3, verbalized understanding and able to repeat back information.”. Interviews held on 06/28/2023, 03/18/2024 and 04/09/2024 revealed that 4 out of 4 staff and three (3) out of four (4) residents have denied the allegation had taken place, while one (1) resident was unable to provide a verbal or visual response. Based on record reviews and interviews conducted, the preponderance of evidence standard has not been met. Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove that the alleged violation occurred. Therefore, the above allegation has been Unsubstantiated. Regarding the allegation “Staff overcharged resident/resident's representative”, it has been alleged that staff had charged for fees related to an Emergency Department visit with R1 on 02/24/2023, when S1 had verified with the family member of R1 that monthly fees were to cover “transportation to all medical appointments.” and “Transportation and accompaniment are offered for all medical appointments. If you or another family member aren't present for an appointment, then our staff will take responsibility for communicating with the medical professionals and confirming new orders. You will receive a follow-up report after the appointment. If you or another family member are present, then our staff will wait for your resident while you're in the appointment together.” S2 later stated that “Family members and/or Legal representatives are responsible to transport and accompany their loved ones to all appointments or emergency medical visits. Otherwise, we must have an additional staff member manage the appointments/emergencies. Therefore, there is an additional charge. The charge is at our cost to afford the employee’s time/pay that we incur. There is no mark-up.” Record reviews revealed that the refund was provided to R1's family member on 04/01/2023, and was paid on 04/02/2023, in the balance of $357.50. Interviews held on 06/28/2023, 03/18/2024 and 04/09/2024 revealed that 4 out of 4 staff and three (3) out of four (4) residents have denied the allegation had taken place, while one (1) resident was unable to provide a verbal or visual response. Based on record reviews and interviews conducted, the preponderance of evidence standard has not been met. Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove that the alleged violation occurred. Report continues, see LIC9099C Therefore, the above allegation has been Unsubstantiated. There have been no deficiencies cited today. An exit interview was held with LaToya Johnson, Administrator (S2), and a copy of this report has been provided.the state’s words, verbatim · CDSS document, Jun 13, 2024 · control 11-AS-20230627141017

Allegation investigated: Staff did not provide proper medication assistance to resident in care.

On 04/09/2024 Licensing program Analyst (LPA) Mario Leon conducted a subsequent complaint visit at the above mentioned facility. LPA was met by Aurora Ortiz, Direct Care Staff Lead and the purpose of the visit was explained. LPA was later met by Adrien Herbas and LaT]oya Johnson, Administrators. The investigation consisted of the following: On 04/09/24 LPA interviewed 4 residents. On 03/18/24 LPA requested training records for all staff who were present during resident one's presence and resident one's hospice care plan. LPA also interviewed two (2) staff who were present at the facility. On 06/28/23 LPA conducted an unannounced complaint visit to the above mentioned facility. LPA was met by Aurora Ortiz, Team Lead, and later by Adrien Herbas, Administrator, who were both informed that this visit was conducted to investigate the above complaint allegation and LPA requested resident roster, staff roster, hospice care plans, physician reports, pre-placement appraisals, appraisals, identification and emergency contacts and other service documents which related to rental fees and back pay. A plant inspection was conducted and above mentioned records were reviewed. Report continues, see LIC9099C. Unsubstantiated The investigation revealed the following: Regarding the allegation: "Staff did not provide proper medication assistance to resident in care.". It has been alleged that the above-mentioned facility could not store or administer proper comfort care medications. Interviews revealed that five (5) out of 5 staff and three (3) out of four (4) residents have denied the allegation, while one (1) resident was unable to provide a verbal or visual response. Record reviews revealed that staff Aurora Ortiz (S3) was properly instructed by a skilled nurse regarding the appropriate administration of comfort care medications for resident one (R1) on 03/01/23 and that there was a stop in morphine administration on 04/11/23. On 05/25/23 R1's registered nurse from Kaiser Hospice (RN), made a visit to R1, upon which S3 was informed by RN to follow order as received. According to Medication Admissions Record (MAR), S3 provided one (1) dose on 05/25/23, 1 dose on 05/27/23, and 4 doses on 05/28/23. On 05/29/23 RN provided a new order for the medication to be administered every six (6) hours, around the clock, and to continue previous order of 1 dose every hour as needed. MAR noted around the clock doses began on 05/29/23. Based on record reviews and interviews conducted, the preponderance of evidence standard has/has not been met. Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove that the alleged violation occurred. Therefore, the above allegation has been Unsubstantiated. An exit interview was conducted with LaToya Johnson, Administrator, and a copy of this report has been provided.the state’s words, verbatim · CDSS document, Apr 9, 2024 · control 11-AS-20230627141017

Allegation investigated: Staff tried to change resident's hospice care plan without proper authorization

On 04/09/2024 Licensing program Analyst (LPA) Mario Leon conducted a subsequent complaint visit at the above mentioned facility to deliver this amended document. LPA was met by Aurora Ortiz, Direct Care Staff Lead and the purpose of the visit was explained. LPA was later met by Adrien Herbas and Latoya Johnson, Administrators. The investigation consisted of the following: On 03/18/24 LPA requested training records for all staff who were present during resident one's presence and resident one's hospice care plan. LPA also interviewed two (2) staff who were present at the facility. On 06/28/23 LPA conducted an unannounced complaint visit to the above mentioned facility. LPA was met by Aurora Ortiz, Team Lead, and later by Adrien Herbas, Administrator, who were both informed that this visit was conducted to investigate the above complaint allegation and LPA requested resident roster, staff roster, hospice care plans, physician reports, pre-placement appraisals, appraisals, identification and emergency contacts and other service documents which related to rental fees and back pay. A plant inspection was conducted and above mentioned records were reviewed. Report continues, see LIC9099C. Substantiated The investigation revealed the following: Regarding the allegation "Staff tried to change resident's hospice care plan without proper authorization". It has been alleged that one hospice provider was requested not to return to the above-mentioned facility. Interviews revealed that two (2) out of 2 staff members have agreed that one worker was requested not to return to the facility. LPA's record reviews revealed that the facility does not contain a written hospice care plan for resident one. According to the terms and conditions of the hospice waiver, approved on 09/17/2021, section 6 is stated as follows: "Prior to the initiation of hospice services in the facility, the licensee will ensure a written hospice care plan is developed for each terminally ill resident or prospective resident, that specifies the care, services, and necessary medical intervention related to the terminal illness as necessary to supplement the care and supervision provided by the facility by that resident’s hospice agency, and agreed to by both the licensee and the resident or prospective resident or the resident’s or prospective resident’s Health Care Surrogate Decision Maker.". The facility was unable to provide a copy of any incident report(s), LIC624, of the incident; which has been mandated by the reporting requirements of the department, California Code of Regulations 87633(g). Based on record reviews and interviews conducted, the preponderance of evidence standard has been met. Therefore, the above allegation is found to be Substantiated. California Code of Regulations, Title twenty-two (22), Division six (6) is being cited on the attached deficiency. Please see LIC9099D. An exit interview was held with Latoya Johnson, Administrator, and a copy of this report and appeal rights have been provided.the state’s words, verbatim · CDSS document, Mar 18, 2024 · control 11-AS-20230627141017

From the deficiency page — Deficiency type: Type B · Section cited: CCR 87633(g) · Plan of correction due date: Mar 22, 2024

(g) In addition to...section 87211, Reporting Requirements, the licensee shall submit a report to the department when...hospice services are interrupted or discontinued for any reason other than the death of the resident, including refusal of hospice care or discharge from hospice. The licensee shall also report any deviation from the resident’s hospice care plan, or other incident, which threatens the health and safety of any resident. This has not been met as evidenced by: a requested change of a social worker, which had not been reported to the department.the state’s words, verbatim · CDSS document, Mar 18, 2024

Plan of correction: The administrator and LPA have agreed that any incident resulting in any deviation, or incident, of a resident's hospice care plan will be reported to the department of social services via fax number at 424.544.1016. Licensee will let LPA know about reception of this deficiency and will forward an update to their admission agreement which includes, but not limited to, section 6 of the hospice waiver approval letter, approved on 09/17/2021 via email to mario.leon@dss.ca.gov