Lovejoy's Greenhouse

Type of visit: Case Management - Other

At approximately, 8:30 AM Licensing Program Analyst (LPA) Robert Frank arrived at Lovejoy’s Greenhouse for the purpose of a closure inspection pursuant to voluntary closure of this licensed Residential Care Facility for the Elderly. LPA met with Linda Ruhaka, daughter of Licensee/Administrator, who submitted the written notice letter of facility closure to the Santa Rosa Regional Office via e-mail on 06/13/2025. LPA inspected all rooms and the exterior of the building today and observed no evidence that would suggest that any residents are residing on the premises. The closure of this facility has been finalized. Facility is closed effective 07/11/2025. Licensee’s daughter surrendered Facility’s License during today's inspection. No deficiencies cited during today's visit. Exit interview conducted. Copy of report discussed and provided to Linda Ruhaka. Signature on form confirms receipt of documents.the state’s words, verbatim · CDSS document, Jul 11, 2025

Allegation investigated: Staff isolates resident in room for extended periods of time. Staff does not ensure resident's showeing needs are being met. Staff mismanages resident's medicaiton log.

Licensing Program Analyst (LPA) Christi Coppo arrived at this facility deliver complaint findings on the above allegations. LPA met with Administrator Linda Ruhake. Complaint alleges staff isolates resident in room for extended periods of time. During investigation, LPA interviewed facility administrator. Administrator gave LPA hour by hour accounting of typical schedule of care given to R1. Admin indicated to LPA that resident spends all their time in their room except for the times they are eating lunch and/or dinner, or on the occasion when R1 hangs out in the living room for a bit after eating lunch and/or dinner. Admin indicated to LPA that while present at the facility, R1 spends most of their time in their room watching TV, eats breakfast in bed and remains in their bed for up to 4 consecutive hours at a time. During visit to facility, LPA did not observe any activities being conducted or available for residents. Based on LPA’s interviews and observation, the preponderance of evidence standard has been met, Continued on 9099C... Substantiated Continued form 9099... therefore the above allegation is found to be SUBSTANTIATED. California Code of Regulations, Title 22, Division 6 Chapter 8, are being cited on the attached 9099D. Complaint alleges staff does not ensure resident's showering needs are being met. During investigation, LPA reviewed R1’s physician report in which it states that R1 is at risk if allowed direct access to personal grooming and hygiene items as well as having a lack of capacity to bathe or dress/groom themselves. Additionally, R1 is non-verbal and cannot refuse showers. During investigation, Admin indicated to LPA that R1 gets bed baths every day and that R1 gets showered two [2] times per week, but that showers occur on random days of the week. During investigation, LPA reviewed facility shower logs from 4/1/25-4/30/25. LPA review of shower log indicates that R1 was only showered three [3] times in the month of April on 4/12, 4/19, and 4/27. Based on LPA’s interview and record review, the preponderance of evidence standard has been met, therefore the above allegation is found to be SUBSTANTIATED. California Code of Regulations, Title 22, Division 6 Chapter 8, are being cited on the attached 9099D. Complaint alleges staff mismanages resident's medication log. Complainant states that resident's medications are not being documented in the medication log each time the resident is being administered a medication. During investigation, LPA reviewed R1’s physician report in which it states that R1 is not able to administer their own medications or communicate their needs. During investigation, LPA reviewed Medication Administration record (MAR) for R1 and current physician’s medication orders for R1. LPA observed incomplete MAR records for both R1’s prescription and PRN medications. Admin acknowledged incomplete MAR records. Additionally, facility did not list the time at which any PRN medications were administered, as required per regulation 87465(d)(3), So, based on LPA’s interview and record review, the preponderance of evidence standard has been met, therefore the above allegation is found to be SUBSTANTIATED. California Code of Regulations, Title 22, Division 6 Chapter 8, are being cited on the attached 9099D. Deficiencies cited from the California Code of Regulations, Title 22, Division 6 of California Regulation and the Health and Safety Code. Appeal rights given and discussed with Administrator. Failure to correct the deficiency and/or repeat deficiencies within a 12 month period may result in civil penalties. Exit interview conducted with Administrator and a copy of this report was given. Continued from 9099A... also states that I1 indicated to doctor that I1 thinks that R1’s mobility at the facility significantly helps their stool impaction. During investigation, LPA interviewed I1. I1 indicated that the agreement with the facility was that facility Admin would contact I1 for any medical attention that R1 needed that is related to their baseline behavior or known medical issues. Once notified by the facility Admin, I1 would then contact the doctor or transport R1 to receive medical attention. So, the agreement was that the facility would contact I1 and then I1 would make the appointment or take R1 to the hospital when medical attention was thought to be necessary or beneficial. Admin advised LPA that the facility did not observe any new symptoms or behaviors outside of R1’s baseline behavior or known medical issues of vomiting and constipation, so that is why facility did not contact emergency services on 1/22/25; rather, facility contacted I1, as per the facility's agreement with I1. LPA reached out to I1 on three occasions after initial interview for clarification: on 6/2/25, 6/9/25, and 6/12/25 but contact attempts were unsuccessful. Additionally, on 4/28/25, 4/30/25, 5/8/25, and 6/16/25 LPA reached out to R1’s North Bay Regional Center case worker for interview, but LPA attempts were unsuccessful. So, 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, therefore the allegation is UNSUBSTANTIATED. Complaint alleges staff does not follow resident's food diet. Complainant alleges staff are not following R1’s meal plan. During investigation, LPA reviewed physician report for R1, no special meal plan indicated other than dental soft food diet. During investigation, LPA also reviewed suggested meals for R1 provided to facility from R1’s responsible party. LPA observed food in facility designated for R1 to match foods listed on R1’s responsible party’s suggested meal plan and that of dental soft diet. So, 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, therefore the allegation is UNSUBSTANTIATED.the state’s words, verbatim · CDSS document, Jun 17, 2025 · control 21-AS-20250425151330

From the deficiency page — Deficiency type: Type B · Section cited: CCR 87468.2(a)(4) · Plan of correction due date: Jul 1, 2025

87468.2 Additional Personal Rights...(a) In addition to the rights listed in Section 87468.1...residents...shall have all of the following personal rights: (4) To care, supervision, and services that meet their individual needs and are delivered by staff that are sufficient in numbers, qualifications, and competency to meet their needs. This requirement not met by licensee as evidenced by: Based on LPA interview, resident in isolated in bedroom for extended periods of time, which poses an potential health, safety or personal rights risk to persons in care.the state’s words, verbatim · CDSS document, Jun 17, 2025

Plan of correction: Licensee has decided to close facility. LIcensee will forward to CCL copies of Closure plan and 60 day notice given to residents by plan of correction due date. Plan and notice to be in compliance with HSC 1569.682 Transfer of resident upon forfeiture of license or change in use of facility; duties of licensee; closure plan; duty of department upon licensee’s failure to comply; civil penalties. Per Admin, residents have already found a new facility and facility will be closed no later than July 30, 2025

From the deficiency page — Deficiency type: Type B · Section cited: CCR 87465(d)(3) · Plan of correction due date: Jul 1, 2025

87465 Incidental Medical and Dental Care (d) If the resident is unable to determine his/her own need for a prescription or nonprescription PRN medication, and is unable to communicate his/her symptoms clearly... all of the following requirements are met (3) The date and time the PRN medication was taken, the dosage taken, and the resident's response shall be documented and maintained in the resident's facility record. This requriemebt not met by licensee as evidenced by: Based on LPA record review and interview licensee did not maintain complete MAR records for both R1’s prescription and PRN medications, which poses an potential health, safety or personal rights risk to persons in care.the state’s words, verbatim · CDSS document, Jun 17, 2025

Plan of correction: Licensee has decided to close facility. LIcensee will forward to CCL copies of Closure plan and 60 day notice given to residents by plan of correction due date. Plan and notice to be in compliance with HSC 1569.682 Transfer of resident upon forfeiture of license or change in use of facility; duties of licensee; closure plan; duty of department upon licensee’s failure to comply; civil penalties. Per Admin, residents have already found a new facility and facility will be closed no later than July 30, 2025

From the deficiency page — Deficiency type: Type B · Section cited: CCR 87468.2(a)(4) · Plan of correction due date: Jun 17, 2025

87468.2 Additional Personal Rights...(a) In addition to the rights listed in Section 87468.1...residents...shall have all of the following personal rights: (4) To care, supervision, and services that meet their individual needs and are delivered by staff that are sufficient in numbers, qualifications, and competency to meet their needs. This requirement not met by licensee as evidenced by: Based on LPA interview and record review, facility is not meeting resident's showering needs, which poses an potential health, safety or personal rights risk to persons in care.the state’s words, verbatim · CDSS document, Jun 17, 2025

Plan of correction: Licensee has decided to close facility. LIcensee will forward to CCL copies of Closure plan and 60 day notice given to residents by plan of correction due date. Plan and notice to be in compliance with HSC 1569.682 Transfer of resident upon forfeiture of license or change in use of facility; duties of licensee; closure plan; duty of department upon licensee’s failure to comply; civil penalties. Per Admin, residents have already found a new facility and facility will be closed no later than July 30, 2025

Type of visit: Office

Licensing Program Analyst (LPAs) Christi Coppo and Robert Frank and Licensing Program Manager (LPM) Victoria Bertozzi met with Lovejoy's Greenhouse acting Administrator Linda Ruhaka, Administrator Martha Lovejoy and Tuamana Ruhaka. During this meeting items were discussed pertaining to the operation of the facility. The following identified areas of concern were addressed. Staff training Staff Health Screening and TB clearance Resident Appraisals Administrator responsibilities and duties Financial Management of facility operation requirements CAB contact information for potential change of ownership: https://cdss.ca.gov/inforesources/community-care/ascp-centralized-application-units CCL discussed with attendees changes to regulations effective January 1, 2025 including but not limited to regulation 87463 as pertains to resident appraisals and medical assessments. CCL discussed financial operation of facility requirements. CCL discussed with attendees intentions regarding the Administration of the facility. CCL offered the department's Technical Support Program (TSP) to licensees. Acting Administrator expressed desire to participate in TSP. CCL will submit referral. No deficiencies cited. Exit interview conducted with acting Administrator.the state’s words, verbatim · CDSS document, Apr 8, 2025

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Christi Coppo arrived unannounced to conduct a required Annual inspection and was greeted by caregiver. Administrator (Admin) Martha Lovejoy has a current certificate #7035932740 expires 6/26/25. Admin was not available to come to the facility, but gave caregiver permission to sign report. Licensee will be changing the Administrator from Martha Lovejoy to new Administrator. Licensee will send in the required paperwork to CCL within 10 business days of this report. At approximately 2:00pm LPA and caregiver toured the building and grounds. The facility was found to be clean and at a comfortable temperature. Large bay windows in master bedroom are single pane and have some moisture or water pooling in the sills. Window sills and wood border on the bottom are covered in a black film and spots of a black substance are present on the sides of the windows. Licensee will ensure windows are free from black substance before any new residents occupy the master bedroom, as it is not currently occupied. LPA observed at least a 2 day supply of perishable and 7 day supply of non-perishable food. Food was found to be stored in a safe manner with open items covered. LPA did not observe any fresh fruits or vegetables present. LPA and caregiver discussed adding some fresh fruits and vegetables to the residents' diet so that the food provided is not only processed foods. Kitchen cabinet containing cleaning supplies was locked. Kitchen drawer with sharp knives locked. All bedrooms were equipped with night stand and chest of drawers. All bedrooms need a lamp. All bedrooms were clean and in good repair. Extra hygiene products and linens were available. Resident bathroom had required bath mat and grab bar. Water temperature in sink accessible to residents in care measured at 123.2 degrees F in room #2 and 123.3 degrees F in room #6, both of which are not within the allowable range of 105 to 120 degrees F (deficiency cited, see 809D) Continued on 809C... Continued from 809... Fire extinguishers were last inspected 12/21/2023, but are showing as charged. Licensee to have fire extinguishers serviced as soon as possible. Smoke/Carbon Monoxide detectors located throughout the facility were tested and operational. Facility’s quarterly disaster drills have not been conducted (deficiency cited, see 809D) At approximately 3:30pm LPA conducted a review of 2 resident records. R1 did not have TB results on file (deficiency cited, see 809D). R2 had a handwritten information sheet completed by licensee. LPA discussed with licensee that a complete appraisal needs to be completed for each resident both upon move-in and annually thereafter, ideally completed on a LIC form. Half rails present for both residents but neither had doctor's orders on file. At approximately 4:00pm LPA conducted review of 3 staff records. S1 and S2 did not have any annual training completed (deficiency cited, see 809D). S1 did not have a Health Screen on file and S2 did not have TB clearance/test results on file (deficiency cited, see 809D). At approximately 4:30pm LPA conducted a spot check of medication and medication records. Medication is centrally stored in a locked cabinet. Over the counter medications found in room #2 medicine cabinet: Simethicone 125mg, hydrocortisone cream 1%, and Benzethonium chloride 0.2% cream (deficiency cited, see 809D). Updated copies of the following documents were requested for facility file and are to be submitted to CCL within 30 days of this visit: LIC500- Personnel Report, LIC308- Designation of Responsibility, Liability Insurance, and Current Lease Deficiencies cited from the California Code of Regulations, Title 22, Division 6 of California Regulation and the Health and Safety Code. Appeal rights given and discussed with caregiver. Failure to correct the deficiency and/or repeat deficiencies within a 12 month period may result in civil penalties. Exit interview conducted with caregiver and a copy of this report was given.the state’s words, verbatim · CDSS document, Dec 17, 2024

The state marks this report as 10 pages; the online copy we transcribed has 6. You can request the full file from the county licensing office.

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Victoria Bertozzi arrived unannounced to conduct an Annual Required inspection and was met by staff. Licensee/Administrator, Martha Lovejoy came later but was unable to stay. Caregiver was given permission to sign report. LPA initiated a tour of the facility around 12:30pm and made the following observations: Facility was a comfortable temperature and passageways were free from obstructions. Resident rooms were furnished per regulation. Water temperature in bathrooms used by residents measured at 109 and 116 degrees F which are within the range of 105 to 120 degrees F allowed per regulation. Extra hygiene products and linens were available. Cabinet containing cleaning supplies was locked. Facility has at least two days of perishable and one week of non-perishable foods which appeared to be of quality and stored per regulation. Medications were centrally stored and locked. Fire extinguishers were last serviced November 2022. Smoke and Carbon Monoxide detectors located throughout the facility were tested and operational. Licensee does not have record of a fire/disaster drill conducted in the last quarter. Four staff files and three resident files were reviewed. have required First Aid and CPR certificates. Administrator Certificate for Administrator, Martha Lovejoy has expired but is on the Department's Pending List. Continued on LIC809C Continued from LIC809 Licensee/Administrator to submit updates of the following documents by 11/27/2022: LIC 308 Designated Administrator (if applicable) LIC 500 Personnel Summary LIC 610 Emergency Disaster Plan (review and update if changes) Infection Control Plan (if changes) Liability Insurance Deficiencies cited from the California Code of Regulations, Title 22, Division 6 of California Regulation. Appeal rights given. Failure to correct the deficiency and/or repeat deficiencies within a 12 month period may result in civil penalties.the state’s words, verbatim · CDSS document, Nov 27, 2023