Knott's Landing Luxury Care

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Jerome Haley conducted an unannounced visit for the purpose of conducting a required one-year annual inspection. LPA was greeted, granted entry by staff and explained the reason for the visit. Structure: The facility is a single level structure and licensed for six residents (6 non-ambulatory) and has a hospice waiver for six. As of today, the facility has six residents admitted. All residents were present during the visit, and one left for their day program shortly after the visit began. There is a total of 4 bedrooms (3 resident & 1 staff) and 2 bathrooms areas (1 Resident & 1 Staff). There’s a living room space, a dining space, backyard and an attached garage. Bedrooms: All bedrooms have the required furnishings: bed, lamp, chair, and storage space. Bathroom(s): Bathrooms are equipped with a working toilet, wash basin, and shower. Hot water was measured in the range of 110.6 and 114.8 degrees F. Kitchen: 4 of 5 burners are operational on the gas stove. The center burner will not light unassisted. No sharps or cleaning solutions are stored in the kitchen. Food Service: A supply of perishable and non-perishable food items that meet regulation requirements was observed in the kitchen. Additional food and water was observed in the garage. Resident & Staff Files: Resident and staff files are stored in the locked filing cabinet in the kitchen. File Review: Three resident files were reviewed during the visit, and three staff files were reviewed. Medications/First-Aid Kit: Resident medications are stored in the locked medication cabinet in the kitchen. A first aid kit with all the required elements was observed in a cabinet in the kitchen above the printer. Medication Review: Three resident medications were reviewed during the visit. No discrepancies were observed. Medication is being administered as prescribed. Continued on LIC809C Linens & Hygiene Supplies: Additional linens and incontinent care items were observed in the main hallway closets. Resident hygiene caddy’s are stored in the locked staff bedroom. Garage Area: The garage is organized and walkways are free of obstruction. There’s a laundry area with a washer and dryer. Soaps and cleaning solutions are stored in a cabinet. There’s an additional fire extinguisher mounted in the garage by the door. A disaster supply bag and additional first aid kit was observed prepared and ready to go in the event of an emergency. Arts and craft items were observed. Backyard/Exterior: The backyard has a shaded patio area with a table, chairs, and a mounted television. Two locked storage sheds were observed. One storage shed is used for additional nonperishable food storage. The second locked storage shed is used to store miscellaneous resident care items, and additional incontinent care supplies. Incontinent care items and a wheelchair was observed. Administrator was advised to remove any and all items from the garden that may attract rodents and/or insects. Bodies of Water: None. Smoke/Carbon Monoxide Detectors: Smoke and carbon monoxide detectors tested operational. Fire Extinguisher: Fire extinguisher was observed mounted in the main hallway and in the garage. An emergency drill: An emergency drill was conducted January 6, 2026. Disaster drills are conducted quarterly. Emergency Phone Numbers, House Rules, Exit Plan & Menu: Facility postings are posted are available for review on the main postings board in the main hallway area. Additional Comments: Licensing fees are current. Updated facility contact information (mobile number and email) was provided and the profile will be updated Three staff interviews were conducted, one resident interview was conducted and one resident interview was attempted. Deficiencies observed during annual inspection will be cited. An exit interview conducted, and a copy of the report, technical advisory and appeal rights were provided.the state’s words, verbatim · CDSS document, Jan 28, 2026

Type of visit: Required - 1 Year

On January 30, 2025, Licensing Program Analyst (LPA) Eboni Bentley arrived at the facility unannounced, for the purpose of conducting a required annual visit using the CARE Inspection Tool. LPA Bentley was greeted, granted entry by staff, and explained the reason for the visit. Staff called the Administrator (AD) Victoria Paul via telephone who arrived a short time later and was present for the visit. AD Paul has a current Administrator Certificate with an expiration date of March 24, 2026. Administrator Faisal Rajpoot later arrived to close out visit. Knott’s Landing Luxury Care is a one story community with three (3) resident bedrooms, one (1) staff bedroom and two (2) bathrooms. The facility is licensed for six (6) non-ambulatory residents with an approved hospice waiver for six (6) residents. Currently, there are six (6) residents on census of which one (1) is receiving hospice care. All six (6) residents were present during today’s visit. Residents were observed in the living room exercising, in the dining room eating, and later participating in activities. At 9:00AM, LPA Bentley conducted a tour of the physical plant accompanied by AD Paul and the following was observed: There were no bodies of water on the premises, all rooms were inspected, beds and bedding supplies were available, lighting was provided in all rooms, and storage for the residents’ personal belongings were observed in residents’ closets. Additional bed linens, comforters, and bath towels were available during the visit. Bathrooms were operational with water temperatures measured at 116.6 and 117.5 degrees F. in bathrooms throughout the facility. All resident bedrooms were clean, well-organized, and had all necessary items and storage space. The kitchen was clean and organized. All knives and sharp objects were locked in a cabinet near the stove. A two day supply of perishable food items and seven day supply of nonperishable food items was observed. Continued on LIC809C In the kitchen, was a locked file cabinet with resident files. LPA Bentley observed a first aid kit with all the required elements. Two (2) fully charged fire extinguisher were observed mounted with a last service date of December 23, 2024. Smoke detectors were tested and operational. The last fire and disaster drill was conducted on January 6, 2025. The garage was clean and walkways were free of clutter and debris. A refrigerator with a supply of perishable items was observed and a washer and dryer were found in working condition. The backyard was clean and free of clutter and debris. The side exit gates were clear and accessible. A shaded patio area with tables and seating were observed. Two (2) storage sheds were also observed in the back yard, right next to each, with one containing nonperishable and emergency food supply. The facility has and adequate amount of emergency food and water supply. A review of six residents (R1-R6) service files and six (6) staff (S1-S6) personnel files revealed to be complete. Six (6) resident interviews and three (3) staff interviews were conducted during today's visit. The facility has liability insurance on file effective May 17, 2024 through May 17, 2025. A review of the medication and Medication Records Administration (MAR) was conducted, and a technical advisory was issued. No deficiencies were cited during today’s inspection visit. An exit interview conducted and a copy of the report was provided to Administrator Faisal Rajpoot.the state’s words, verbatim · CDSS document, Jan 30, 2025

Type of visit: Case Management - Deficiencies

This unannounced Case Management – Deficiencies inspection is being conducted by Licensing Program Analyst (LPA) Jerome Haley. LPA was greeted and granted entry and explained the reason for the visit upon entry. Staff contacted Administrator (AD) Victoria Paul who arrived a few minutes later and was present the remainder of the visit. Before AD Paul arrived LPA Haley toured the interior of the facility with staff. Upon further investigation of the incident report dated October 30, 2024 for an incident that occurred on the same date (10.30.24) revealed the following information: Due to a lack of supervision, Resident 1 (R1) was able to successfully leave the facility without staff and make it to a neighboring property. R1's whereabouts were unknown for about an hour. Document review revealed R1 has a dementia diagnosis and is unable to leave the facility unassisted. According to S1, R1 was showered and placed back in the bed around 7:00am. Around 7:30am staff realized R1 was missing. An additional facility staff arrived a few minutes later and watched the other residents, while the other staff person went to locate the resident. At 8:08am, R1 was found at a neighbor’s house. As a result of today’s Case Management visit, a deficiency will be cited. An exit interview was conducted and a copy of this report and appeal rights were provided.the state’s words, verbatim · CDSS document, Nov 1, 2024

From the deficiency page — Deficiency type: Type A · Section cited: CCR 87464(f)(1) · Plan of correction due date: Nov 4, 2024

(f) Basic services shall at a minimum include: (1) Care and supervision as defined in Section 87101(c)(3) and Health and Safety Code section 1569.2(c). This requirement was not met as evidenced by: On October 30, 2024 around 7:00am Resident 1 was able to leave the facility unassisted and whereabouts were undetermined for about an hour. This poses a health and safety risk to residents in care.the state’s words, verbatim · CDSS document, Nov 1, 2024

Plan of correction: Administrator Victoria Paul will schedule an in-service training for all staff. After the training is completed, Administrator Paul will email LPA Haley the sign-in sheet for all staff in attendance, a detailed breakdown of the topics covered during the training, and the duration of the training. The in-service training needs to be scheduled for all staff and details need to be emailed to LPA Haley by 12:00 noon on the POC due date.