La Costa Golf RCFE

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Nacole Patterson conducted an unannounced Required Annual Inspection. The facility file was reviewed prior to the visit. LPA was welcomed by and discussed the purpose of the visit to caregiver Aidee Santiago and Administrator Marko Kolomijcev arrived during the visit. The facility's license shows a maximum capacity of 6 (six) non-ambulatory residents, ages 60 and above, with a hospice waiver approved for 6 (six) residents. During today’s inspection there were 6 (six) residents in care. LPA and Administrator toured the interior and exterior of the facility and inspected each room. The facility was clean, sanitary, and in good repair. Pathways were free of obstruction and slip hazards. Client bedrooms contained the required furnishings. Doors, windows, screens, toilets, and showers were in working order. Extra linens and hygiene supplies were present, as well as Personal Protective Equipment. The facility had sufficient space and equipment to facilitate dining, laundry, visitation, meetings, and client activities. The facility contained at least 2 days of perishable food, and at least 7 days non-perishable food, all safely stored. Cooking, dining equipment, and utensils were present. No toxic chemicals or poisons were accessible to clients. Medications were labeled, as required, and stored in locked areas. No pools or bodies of water exist on the premises. Per Administrator Marko Kolomijcev, no firearms or ammunition are kept at the facility. Carbon monoxide detectors, emergency lighting, and facility telephone were all in working order. Fire extinguisher(s) were serviced within the last 12 months. First aid kit(s) were complete and readily accessible. Required licensing postings were observed in visible areas of the facility. LPA interviewed staff and clients, and reviewed facility records. The files reviewed by LPA contained required documents. Confidential records were stored in locked areas. No deficiencies were cited during the inspection. An exit interview was conducted with Administrator Marko Kolomijcev to whom a copy of this report and the Licensee/Appeal Rights (LIC9058 03/22) were provided.the state’s words, verbatim · CDSS document, Nov 6, 2025

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Nacole Patterson conducted an unannounced Required Annual Inspection. The facility file was reviewed prior to the visit. LPA was welcomed by and discussed the purpose of the visit to Administrator David Swagerty. The facility's license shows a maximum capacity of six (6) non-ambulatory residents, ages 60 and above. During today’s inspection there were four (4) residents in care. LPA and Administrator David Swagerty toured the interior and exterior of the facility and inspected each room. The facility was clean, sanitary, and in good repair. Pathways were free of obstruction and slip hazards. Client bedrooms contained the required furnishings. Doors, windows, screens, toilets, and showers were in working order. Extra linens and hygiene supplies were present, as well as Personal Protective Equipment. The facility had sufficient space and equipment to facilitate dining, laundry, visitation, meetings, and client activities. The facility contained at least 2 days of perishable food, and at least 7 days non-perishable food, all safely stored. Cooking, dining equipment, and utensils were present. No toxic chemicals or poisons were accessible to clients. Medications were labeled, as required, and stored in locked areas. No pools or bodies of water exist on the premises. Per Administrator David Swagerty, no firearms or ammunition are kept at the facility. Carbon monoxide detectors, emergency lighting, and facility telephone were all in working order. Fire extinguisher(s) were serviced within the last 12 months. First aid kit(s) were complete and readily accessible. Required licensing postings were observed in visible areas of the facility. LPA interviewed staff and clients, and reviewed facility records. The files reviewed by LPA contained required documents. Confidential records were stored in locked areas. No deficiencies were cited during the inspection. An exit interview was conducted with Administrator David Swagerty to whom a copy of this report and the Licensee/Appeal Rights (LIC9058 03/22) were provided.the state’s words, verbatim · CDSS document, Nov 7, 2024

Allegation investigated: Staff dispensed medications to resident without doctors orders.

Licensing Program Analyst (LPA) Nacole Patterson conducted an unannounced visit to deliver findings regarding the above complaint allegation. LPA introduced herself and disclosed the purpose of the visit to Administrator David Swagerty. On 1/13/23 it was alleged that staff dispensed medication without doctor's orders. The Department’s investigation consisted of unannounced facility visits, review of facility and outside source records, interviews with facility staff, residents, and outside sources. It was alleged that staff administered an over the counter medication to a resident to induce sleep. Staff interview did not corroborate the allegation, staff informed that the only medication administered to residents was ordered by resident physicians and sent to the facility from the pharmacy. Resident interviews did not corroborate the allegation, residents expressing no concerns with medication administration. (Continued on LIC9099-C) Unsubstantiated (Continued from LIC9099) The resident in question was unable to be interviewed. Outside source interviews were inconsistent, one source expressing minor concerns regarding medication administration due to language barriers. Other outside sources did not express concern regarding medication administration or errors. Records review revealed that the medication in question was an active prescription for the resident. Based on interviews, direct LPA observations and records review, a preponderance of evidence does not exist to conclude that the alleged violation occurred, therefore the allegation is UNSUBSTANTIATED. An exit interview was conducted with Administrator David Swagerty, to whom a copy of this report and the Licensee/Appeal Rights (LIC9058 03/22) were provided.the state’s words, verbatim · CDSS document, Dec 27, 2023 · control 08-AS-20230113113814

Allegation investigated: Staff handled resident(s) in a rough manner. Staff did not meet resident(s) needs. Staff did not meet resident(s) incontinence needs. Staff did not administer medication as prescribed.

Licensing Program Analyst (LPA) Nacole Patterson conducted an unannounced visit to deliver findings regarding the above complaint allegations. LPA introduced herself and disclosed the purpose of the visit to Administrator David Swagerty. On 1/13/23 it was alleged that staff handled resident(s) in a rough manner, staff did not meet resident(s) needs, staff did not met resident(s) incontinence needs, and staff did not administer medication as prescribed. The Department’s investigation consisted of unannounced facility visits, review of facility and outside source records, interviews with facility staff, residents, outside sources, and LPA direct observations. Regarding the allegation, "Staff handled resident(s) in a rough manner", staff interviews did not corroborate the allegation; all staff members denied observing any staff handling a resident in a rough manner. Resident interviews did not corroborate the allegation, residents interviewed did not express concern regarding their physical interactions with staff. (Continued on LIC9099-C) Unsubstantiated (Continued from LIC9099) Outside sources interviewed did not corroborate the allegation, expressing no concerns in their observations of staff physically assisting residents, and not being informed by residents of rough handling concerns. Outside sources indicated that the language barrier and cultural miscommunications have resulted in misunderstandings. No records were found to support the allegation. The resident in question was unable to be interviewed. Regarding the allegation, "Staff did not meet resident(s) needs", it was alleged that staff did not respond to resident(s) call and/or provide assistance when needed. Staff interviews revealed that staff respond timely and frequently to resident requests and needs. Residents interviewed informed that staff assist them with their needs and respond when called. Outside source interviews were mixed, some sources stated they had no concerns, and other sources expressed concern regarding staff assistance during the night and follow through for therapies. No records were found to support the allegation. During three (3) unannounced facility visits, LPA directly observed staff members assisting residents when they heard the residents call out for assistance. LPA observed that staff did not always hear the residents call out every time, but once the call was heard, staff assisted within minutes. LPA spoke with the Administrators regarding how to ensure residents were heard on the first call. The resident in question was unable to be interviewed. Regarding the allegation, "Staff did not meet resident(s) incontinence needs", it was alleged that staff allowed resident(s) to remain in soiled briefs for long periods of time and double-diapered them. Staff interviews did not corroborate the allegation, staff informed that residents were changed 5-10 times per day, depending on individual needs and requests. Staff interview further revealed that for certain residents with more significant incontinence issues, an additional bed pad was used in the form of a second brief cut on the sides and laid flat on top of the bed. Resident interviews did not corroborate the allegation, residents stated they were assisted by staff with toileting and upon request. Outside source interviews confirmed observing that some residents were provided a second brief for incontinent issues, but noted that it was not done to keep staff from providing incontinence duties. Outside source interview further revealed observations of residents being clean and dry during facility visits, and residents being checked for incontinence throughout the day. No records were found to support the allegation. During three (3) unannounced facility visits LPA observed staff members assisting residents with toileting throughout the day; LPA observed the facility to be free from incontinence odors. The resident in question was unable to be interviewed. (Continued on LIC9099-C) (Continued from LIC9099-C) Regarding the allegation, "Staff did not administer medication as prescribed", it was alleged that staff administered a pro re nata (PRN) medication to a resident (R1) at intervals more frequent than the prescription allowed. Staff interviews did not corroborate the allegation, staff denied that PRNs were provided more frequently than the prescription, as the medications were audited by management weekly with no errors having been noted. Residents interviewed stated that they received their medications timely and correctly from staff. Outside source interviews did not reveal concerns regarding medication administration. Outside source interviews further revealed that the medication was prescribed to the resident and was administered within the prescription requirements. No records were found to corroborate the allegation. The resident in question was not able to be interviewed. Based on interviews, direct LPA observations and records review, the investigation did not yield sufficient evidence to conclude that the alleged violation(s) occurred, therefore the allegations are UNSUBSTANTIATED. This finding means that although the allegations may have happened or may be valid, there is not a preponderance of the evidence to prove that they occurred. An exit interview was conducted with Administrator David Swagerty, to whom a copy of this report and the Licensee/Appeal Rights (LIC9058 03/22) were provided.the state’s words, verbatim · CDSS document, Dec 27, 2023 · control 08-AS-20230113081334

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Nacole Patterson conducted an unannounced Required Annual Inspection. The facility file was reviewed prior to the visit. LPA was welcomed by and discussed the purpose of the visit to Manager David Swagerty. The facility's license shows a maximum capacity of six (6) non-ambulatory residents. During today’s inspection there were 4 residents in care. LPA and caregiver Violeta Stojkovska toured the interior and exterior of the facility, and inspected each room. The facility was clean, sanitary, and in good repair. Pathways were free of obstruction and slip hazards. Client bedrooms contained the required furnishings. Doors, windows, screens, toilets, and showers were in working order. Extra linens and hygiene supplies were present, as well as Personal Protective Equipment. The facility had sufficient space and equipment to facilitate dining, laundry, visitation, meetings, and client activities. Facility contained at least 2 days of perishable food, and at least 7 days non-perishable food present, all safely stored. Cooking/dining equipment and utensils were present. No toxic chemicals/poisons were inaccessible to clients. Medications were labeled, as required, and stored in locked areas. No pools or bodies of water exist on the premises. Per licensee, no firearms or ammunition are kept at the facility. Carbon monoxide detectors, emergency lighting, and facility telephone were all in working order. Fire extinguisher(s) were serviced within the last 12 months. First aid kit(s) were complete and readily accessible. Required licensing postings were observed in visible areas of the facility. LPA interviewed staff and clients, and reviewed staff and client records/files. The files reviewed by LPA contained required documents. Confidential records were stored in locked areas. No deficiencies were cited during the inspection. An exit interview was conducted with Manager David Swagerty to whom a copy of this report and the Licensee/Appeal Rights (LIC9058 03/22) were provided.the state’s words, verbatim · CDSS document, Nov 28, 2023