Kelly's Place #2

Type of visit: Required - 1 Year

Licensing Program Analysts (LPA) Seo Jeon and Ferrer Sabarias conducted an unannounced annual required visit. Upon entry, LPA was greeted by Rosa Quintana, caregiver, and informed them of the purpose of the visit. At the time of the visit, there were (2) staff members and (6) residents present. Facility Overview: The facility is a one-story home with (5) bedrooms and (3) bathrooms, including an attached garage. There are no pools or firearms on the premises. Infection Control: LPA observed that hygiene and cleaning supplies were available for regular facility maintenance. The facility’s infection control plan was reviewed and found to meet department requirements. Physical Plant: The physical plant, including floors, windows, and doors, was clean and well maintained. Fixtures and furniture were in good repair. The outdoor area was free of hazards. Laundry equipment was in good working condition. Sharp and dangerous objects were securely locked and inaccessible to residents. Fire extinguisher next to facility kitchen had current inspection tag. Both the smoke detector and carbon monoxide detector were operational, and the hot water temperature was 106.6°F. Food Service: The facility’s kitchen was clean and equipped to prepare food. The facility maintained the required two-day supply of perishable foods and a seven-day supply of non-perishable foods. Continued on LIC809-C.... Care & Supervision/Administration: Adequate staff were present to supervise clients during the visit. The administrator holds a current administrator’s certificate. Record Review and Resident/Staff Files: LPA reviewed files for three staff members, confirming criminal clearances, updated training, and CPR/First Aid certification. Six resident files were reviewed and contained all required documentation. Health-Related Services/Incidental Medical Services: All resident medications were securely locked. LPA reviewed medications for three residents, confirming that all medications were listed on the Medication Administration Record (MAR) and accounted for. Disaster Preparedness: LPA reviewed the facility’s emergency and disaster plan, including documentation of the last quarterly fire drill conducted on 8-30-2024, which met department requirements. All facility exits were clear of obstructions. No deficiencies were cited during the visit. An exit interview was conducted, during which this report was reviewed and provided to Kelly Hentzen, administrator.the state’s words, verbatim · CDSS document, Oct 18, 2024

Allegation investigated: Resident was financially abused while in care

Licensing Program Analyst (LPA) Jesse Gardner conducted an unannounced visit to investigate the above allegation. LPA met with Caregiver Amelia Ramirez. The investigation included interviews with staff, a review of facility documentation, and an inspection of the facility. The residents related to this investigation passed away prior to the concerns reported to the Department, therefore, LPA was unable to interview residents. Allegation #1 stated that a resident was being financially abused. Information was reported that Resident 1 (R1) had paid for landscaping and a freezer for the facility. Licensee denied soliciting funds from R1. Continued on LIC9099C Unsubstantiated Licensee stated prior to R1 becoming a resident, R1 donated money toward a section of pavers in the backyard; however, LPA was not able to confirm this information. R2 also provided a plaque to be placed in the garden in honor of R2’s spouse who was a former resident at the facility; however, LPA was not able to confirm this information. The Licensee stated the freezer was not purchased by R1. Licensee provided a receipt to show proof of purchase which revealed the credit card used for the freezer purchase belonged to the Licensee. Additional information provided by another witness provided conflicting information, therefore this allegation could not be corroborated. Based on staff interview and record review, the allegation that resident was financially abused, is Unsubstantiated. A finding of UNSUBSTANTIATED means that although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation did or did not occur. An exit interview was conducted where a copy of this report was reviewed with and provided.the state’s words, verbatim · CDSS document, Oct 27, 2023 · control 18-AS-20211007155211

Type of visit: Required - 1 Year

On 10/19/2023, Licensing Program Analyst (LPA) Janira Arreola conducted an unannounced annual required visit. LPA was granted entry and met with Licensee, Kelly Hentzen, who was informed of the purpose of the visit. At the time of the visit there was (2) staff and (6) residents present. The facility is a one story home with (6) bedrooms and (3) bathrooms. The residents served are elderly ages 60 and above. LPA conducted a tour of the interior and exterior and observed the following: Infection Control: The LPA observed hand washing stations with hand hygiene supplies and hand washing signs. LPA observed PPE equipment and cleaning supplies to do regular cleaning of the facility. The facility has a plan to train and follow infection control guidelines. Physical Plant: Physical plant was observed to be clean and in good repair. The indoor and outdoor areas were observed to be free of hazards. Laundry equipment was observed to be in good working condition. The sharp and dangerous objects were observed to be locked and inaccessible to residents. The smoke detector and carbon monoxide was operational, and the hot water temperature was recorded at 105F. Food Service: LPA observed facility kitchen had the ability to prepare food in clean environment and possessed equipment in good working condition. LPA observed the facility met the required 2-day supply of perishable and 7-day supply of non-perishable foods. Record Review and Resident/Staff Files: LPA reviewed (2) staff files and training. All staff have criminal clearance and updated training along with CPR/First Aid Certification. The listed administrator showed the LPA proof of a pending administrator's certificate. Two (2) resident files were reviewed, and possessed all required paperwork. Health Related Services/ Incidental Medical Services: All client medication was locked. Resident medications were reviewed, all of which were accounted for. Disaster preparedness: LPA reviewed the facility's emergency and disaster plan. The last fire drill was conducted 9/6/2023. LPA observed emergency exits and emergency supplies. No deficiencies were cited at the time of the visit. An exit interview was conducted where a copy of this report was provided to Licensee, Kelly Hentzen.the state’s words, verbatim · CDSS document, Oct 19, 2023