Lynn's RCFE #2

Type of visit: Required - 1 Year

On 11/01/2023, Licensing Program Analyst (LPA) Brian Phillips arrived at the facility unannounced to conduct an Annual facility Site Inspection Visit. LPA met with Jocelynn Chico, Licensee/Administrator and Ceazar Chico, Licensee, and announced the purpose of the visit. The LPA toured the physical plant areas inside and outside to ensure there are no health and safety hazards and facility is in compliance with Title 22 Regulations. This is a Residential Care for the Elderly (RCFE) consisting of 4 bedrooms, 2 restrooms, a kitchen, dining room, living room, family room, laundry room area, Staff room, Administrator Office area where medications are centrally stored and locked inaccessible to residents), and a garage area. This facility is approved for an age range of 60 years and older, with fire clearance approval for six (6) non-ambulatory residents. The facility has a Hospice waiver for two (2) residents. KITCHEN: The LPA inspected the kitchen/food service area and observed that knives/sharp instruments are stored in locked drawer inaccessible to residents. Kitchen appliances were in operable condition and looked clean/in good repair. The LPA observed perishable items in good condition, with proper expiration dates precluding the perishable items from expiring. The facility has a sufficient supply of perishable and non-perishable food, which would last over a week (7 days). Additional perishable food items were maintained in storage area in the garage of the facility as well as in extra refrigerator and extra freezer located in the garage of the facility. The hot water temperature was measured in the kitchen at an appropriate temperature as per the regulation between 105-120 degrees Fahrenheit. Items that could constitute a danger to residents are kept inaccessible to residents in the kitchen area. The kitchen was clean and sanitary, with covered trashcans and operating ventilation systems. No toxic substances are stored in any food preparation or storage area, and all cleaning supplies for the kitchen are kept in a separate area than the food supplies. The freezer and refrigerator were both in the appropriate temperate Fahrenheit. There is enough tableware and utensils for all residents living in the facility, and enough equipment for the storage, preparation, and service of food. Continued on 809-C COMMON AREAS: At the time of the visit, the common areas of the facility (dining room, living room, family room) were observed to be appropriately furnished, with all furniture in good condition. There is a fireplace in the common areas, which is covered and inaccessible. The facility maintained a comfortable temperature. Smoke detector(s) and carbon monoxide detector were tested and operational at the time of the visit. The fire extinguishers were fully charged and are serviced annually. The facility is a 1 story home with 4 resident bedrooms, and a Staff room where the Central medications are stored. The LPA observed required postings throughout the common spaces including Resident Personal Rights and Contact information for Ombudsman as well as Licensing. There are activity supplies and equipment, including activity materials for the residents. All window screens were in good repair. There is appropriate lighting in the common areas of the facility. All passageways through the common areas of the facility were free of obstruction, and all inclines are well-lit with no stairwells/stairs. As the facility has 4 residents total currently with a capacity for 6 residents total, there is no signal system in place. There is a Staff Office area constituting 1 room in the interior of the facility. This area contains a desk, computer, chair, and is the area where the Centrally Stored Medications are kept locked and inaccessible to residents. There is a large aquarium in the family room of the facility which was observed to be clean and in good repair with a number of large fish swimming freely. OUTSIDE/LAUNDRY/MISCELLANEOUS: The front outdoor area of the facility consists of an unlocked gated main entrance, and an open porch with tables and chairs. The front of the facility is contained by a metal gate about four (4) feet high with a gate that remains unlocked. The recycling bin, green waste bin, and trash bins are standard bins with flip lids. Outdoor activity spaces are completely enclosed by a fence and gates or walls. Outdoor activity spaces in the backyard are equipped with furniture for resident use including a patio with an umbrella for shade. All outdoor areas with stairways, inclines, ramps, or open porches have accessibility ramps for residents, and are well-lit. There were no bodies of water noted. A garage is located off the kitchen of the facility and also contains additional supplies/emergency supplies. The designated laundry area is where cleaning products are stored, which are kept locked and inaccessible to residents. The laundry room is accessible through the common area of the facility as an addendum to the Staff room. There was emergency food and water in storage area of the garage which was observed to be in good condition. Cleaning supplies, disinfectants, and other items that could pose a danger to residents are kept in areas inaccessible to residents. There is a first aid kit that includes sterile dressings, bandages, thermometers, scissors, tweezers, and a first aid manual. The vehicles used to transport residents are in safe operating condition with appropriate insurance information. Continued on 809-C LPA noted that outside in the back yard is completely enclosed by two gates on either side of the facility and has appropriate furniture for residents as well as shade. LPA did not observe any noticeable outdoor hazards. There is an auditory delayed egress system in place that alerts the facility through a loud noise when a resident has opened an exit door, which was inspected by the LPA. BEDROOMS: The LPA observed the resident bedrooms, which were furnished appropriately with clean linens, appropriate furnishings, and sufficient lighting. There are 4 designated individual resident rooms in the facility, 1 bedroom for the Staff members of the facility. Bedroom closets also act as storage areas for clean linens, towels, pillows, etc. Each resident bedroom has a single bed, nightstands, and lights and nightstand lamps to provide sufficient lighting. Each closet in all the resident rooms has extra pillows, clean/fresh linens, and appropriate incontinence materials if applicable for any resident. The resident bedrooms are big enough for all beds, furniture, and any resident assistive device a resident might need such as a wheelchair or a walker. Each room has sufficient lighting for each resident. Each resident bedroom has a sliding glass door to the backyard of the facility which are monitored by auditory delayed egress systems in place. RESTROOMS: The facility restrooms were sanitized and in operating condition while the LPA toured the facility. There are 2 shared resident bathrooms in the facility. All restrooms inspected had assisting equipment for residents including grab bars and/or non-skid surfaces. The bathrooms were sufficiently stocked with soap, paper towels, and additional supplies; towels and washcloths are not shared. The hot water temperature was measured in the restrooms at the appropriate degrees Fahrenheit as per the regulations between 105-120 degrees. As the facility only contains 4 residents at the time of inspection, there is at least 1 toilet and sink for each 3 residents, and at least 1 bathtub/shower for each 3 residents. Night-lights are installed in the hallways outside of the common area restrooms. RECORDS: The facility keeps confidential storage of personnel records and resident records on-site at the facility. Personnel records reviews were reviewed for, but not limited to Personnel records, Health assessments with Tuberculosis (TB) test results, Personnel Action Notice, Job Description with date of employment, Employee Rights, Criminal record Statements/Criminal record clearances, first aid/CPR certification that is not expired, and the appropriate training. All staff member personnel records had the appropriate documentation with no expiration of any training. Continued on 809-C Resident records were reviewed for Pre-Admission/Placement appraisals, Physicians Reports, Consent Forms, Personal Rights for Residents, Emergency Information, Release of Medical Information, Needs and Services Plan (ANS), Resident Assessments, Self-management of medications if applicable, Medication Orders, and Medication Logs. All resident records reviewed by the LPA had the appropriate documentation with no missing or incomplete information. MEDICATIONS: The facility maintains a locked centralized storage area for resident medications. The LPA observed the centrally stored medications as well as the Centrally Stored Medication and Destruction Record. Centrally Stored Medications are in a locked cabinet off the kitchen/Staff office area inaccessible to residents. LPA audited the medications for residents and noticed no irregularities or issues concerning the dispensing of medications or the logging of medications. The medications in the facility were labeled appropriately with no additional or prohibited markings by the facility. INFECTION CONTROL: Upon entry, the facility has a central entry point for symptom screening and a sanitation station. The staff members will keep up signs that promote good hand hygiene and symptoms of COVID. The facility has an adequate supply of Personal Protection Equipment (PPE) and the facility is able to obtain additional supplies as needed. The facility’s cleaning protocol is sufficient. If needed, the facility has the capacity to designate a single isolation room if the facility has a confirmed case of COVID-19. The facility’s policies and procedures as it pertains to infection control are adequate. FACILITY DOCUMENTATION: There are required postings throughout the facility, including emergency exiting plans with necessary telephone numbers. The facility has copies of the Application for an RCFE, Applicant Information, Designation of Facility Responsibility, Affidavit Regarding Client/Resident Cash Resources, Surety Bond, Personnel Report, Personnel Record, Health Screening Report, Emergency Disaster Plan for Adult Residential Facilities, Residential Infection Control Plan, Facility Sketch, Plan of Operation, Control of Property, The Job Description for Each Staff Position, Personnel Policy, In-Service Training for Staff, Facility Program Description, Rules of Discipline/Personal Rights, Admission Agreement for Residents, Theft & Loss Policy, and Job Description for the Administrator. The facility has on file a Dementia Care Waiver(s) and Hospice Care Waiver(s) as this facility is a Residential Care for the Elderly (RCFE) approved for an age range of 60 years and older, with fire clearance approval for six (6) non-ambulatory residents. The facility has a Hospice waiver for two (2) residents. No deficiencies cited. Exit interview conducted. A copy of the report was issued to the facility.the state’s words, verbatim · CDSS document, Nov 1, 2023

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Cortez conducted an on-site 1-year infection control annual visit to the facility above on 10/25/2022 around 11:50 AM. LPA met with Administrator, Jocelyn Chico, and explained the purpose of the visit. LPA then took a physical plant tour of the facility with Administrator. The facility has an entry point at the front door where everyone entering completes sign-in, symptom questionnaire and temperature screening on all staff and visitors wanting to come into the facility. The entry station has hand sanitizer along with a thermometer. The staff screen residents for symptoms and temperature at least once a day and documentation is kept on file. Increased monitoring is conducted if any change of condition is noted or any residents are showing any signs, symptoms, or a temperature. Signs are posted on the front door, entry area regarding Covid-19. Staff makes sure residents have a mask when leaving the facility on outings into the community. All staff wear face coverings in the facility and when on outings with residents. Facility has areas for visiting inside and outside. The facility also offers virtual and telephone communications to all residents in care. Staff, residents, and visitors are informed of the facilities infection control policies. New residents and staff will be tested, and negative results received before working or residing in the facility. The facility has procedures and plans for screening, isolation, testing, when to call 911 and notifying all responsible parties and agencies when needed. The Administrator is in charge of infection control and provides training and education to staff, residents and visitors. Continued on 809-C Staff will use full PPE with N95 masks and face shields when around with any pending or confirmed cases of Covid-19. Facility is able to dedicate a single room for residents so isolation can be arranged when and if needed. The facility contains 6 single rooms. Restrooms that are shared and in private rooms are disinfected and wiped down daily. Precautionary Droplet signs will be posted on any room with quarantined or isolated individuals. PPE supplies will be located right outside those rooms when required. Facility has a 30-day supply of PPE on hand. Facility has plans for delivering medications and meals to any quarantined/isolation resident rooms. Facility Administrator has a plan in place for when and whom to notify in an outbreak or other emergencies. Administrator will keep a line list of all vaccinated and tested staff/residents in care with dates/results. Facility has conducted training on infection prevention, symptoms, transmission, and PPE use. Facility has non-punitive sick leave polices for staff. Sick staff are requested to stay home and not report to work if ill. Residents’ medication is delivered in 30-day supplies to the facility. The facility ensures proper cleaning is done on frequently touched surfaces and between any individuals sharing of space or items. Sinks were well stocked with soap, paper towels and hand washing signs. Staff and resident records are kept in locked cabinets. Facility does realize guidance changes and the most up to date guidance from CCL-PINS, CDC, CDPH, and local health departments should be followed to remain in compliance. Fire extinguishers were charged and inspected annually. At approximately 12:20 PM, LPA reviewed Department of Social Services, Community Care Licensing Division, Licensing Information System (LIS), Facility Personnel and facility staff roster and determined that all staff are fingerprint cleared and associated to the facility All infection control protocols are implemented and are being followed. Exit interview completed and copy of report emailed to Administratorthe state’s words, verbatim · CDSS document, Oct 25, 2022