Minnesota Home Care

Type of visit: Case Management - Other

Licensing Program Analyst (LPA) Sabrina Calzada arrived unannounced to conduct a case management inspection and met with Administrator, Vera Okyere and staff, Clifford Quarshie. LPA stated the reason for the inspection was to follow up on a recent report received from the Ombudsman's office following their visit on August 4, 2026 (1:30 pm). LPA discussed the Ombudsman's report with the Administrator and staff, and there were several discrepancies noted in the report related to the staff and residents mentioned as being present and a resident name missing from the report who was present. Specifically, the following was noted: The Administrator confirmed she was picking up resident's (R1's) medications from the pharmacy, in the early afternoon, when the Ombudsman arrived to conduct their visit and returned within (10) minutes to the facility. Both the Administrator and staff, Quarshie, confirmed (S1) was present at the start of said inspection and provided documents showing (S1) received a fingerprint clearance/association from the Department on July 29, 2026. LPA obtained photo documentation of the clearance and viewed (S1's) Passport for photo identification. The administrator confirmed (S1) is a relative of hers, and there may have been a language barrier in understanding what the Ombudsman was asking. Resident (R1) was finishing up a stay at a skilled nursing facility on August 4, 2026, due to a Urinary Tract Infection (UTI) related to a catheter, and did not return to the facility until Friday, August 7, 2026. (R1) was sent out to the emergency room yesterday, August 11, 2026, due to another possible UTI, related to the catheter, after Home Health was notified and changed it. Additionally, (R2) moved in on June 15, 2026, and is not noted on the Ombudsman's report, dated August 4, 2026. Staff (S2) was not present on August 4, 2026, as they left to go on vacation around June 4, 2026. LPA reviewed Department documentation showing (S2) was present on May 19, 2026, during a case management inspection. *cont on 809C-1.. 809C-1.. LPA observed (3) locked medication cabinets in the kitchen at the start of today's inspection. The Administrator stated that she changed from using a key lock to a magnetic lock about (3) months ago. LPA observed the sharps drawer to be also locked, using a magnetic lock, as well as the cabinet storage below the kitchen sink. The Administrator will look for and provide documentation as to when the magnetic locks were purchased. LPA and the Administrator conducted a tour of the facility, including the food on hand. LPA observed fresh eggs, oranges, applesauce and cookies in the main refrigerator and additional perishable food stored in the spare refrigerator in the pantry area. LPA observed a variety of 7+day of non-perishable food in the pantry area that has a future expiration date/s. LPA reminded the Administrator of the requirement that at least (1) staff always be present with the residents at the facility and how sharps and medications must always be locked, inaccessible to residents. The Administrator will provide an update on when (R1) returns from the recent hospitalization. LPA and the Administrator also discussed any updates on the a Guardian/Conservatorship for resident (R3). There are no deficiencies issued in this report. Exit interview. Copy of report provided.the state’s words, verbatim · CDSS document, Aug 12, 2026

Type of visit: Case Management - Other

Licensing Program Analyst (LPA) Sabrina Calzada arrived unannounced to conduct a case management inspection and observed Administrator, Vera Okyere, arriving back to the facility from attending a medical appointment with resident (R1). LPA stated the reason for the inspection. Also present was staff, Josephine Ellonye. (R1) sat in the common area upon returning to the facility. LPA and the administrator discussed prior resident (R2) who resided at the facility for a short time in December 2024. The administrator stated she would check the file that is in storage and provide LPA with Pre-Appraisal documents. The administrator stated she recalls (R2) attuning a scheduled medical appointment and then was referred to the Emergency Room, due to possibly a kidney or liver issue. The administrator stated she would have sent her out as soon as she noticed a change in condition. LPA discussed the medical appointment (R1) had today with their primary care physician. The administrator stated the physician attempted to contact the Guardian's office two times today and was not able to speak to anyone. The administrator will follow up and attempt to contact the Guardian's Office. The dietician will follow up with the administrator about placing (R1) back on Ensure nutritional drinks due to (R1) losing (3) lbs. LPA took a quick tour and did not observe any health and safety violations or personal rights violations. One of the residents had a family member visiting. The inside temperature was noted as 72*F. There are no deficiencies in this report. Exit interview. Copy of report provided.the state’s words, verbatim · CDSS document, May 19, 2026

Type of visit: Post Licensing

Licensing Program Analyst (LPA) Sabrina Calzada arrived unannounced to conduct a case management inspection and initially met with Josephine Ellonye and then with Administrator, Vera Okyere. LPA stated the reason for the inspection. LPA observed a family member depart after visiting with a resident in their room. All other residents were resting in their rooms during the inspection. The purpose of this document is to clear the Post Licensing Inspection that is still showing in the system. There are no deficiencies issued in this report. Exit interview. Copy of report provided.the state’s words, verbatim · CDSS document, Apr 23, 2026

Type of visit: Case Management - Incident

Licensing Program Analyst (LPA) Sabrina Calzada arrived unannounced to conduct a case management inspection and initially met with Josephine Ellonye and then with Administrator, Vera Okyere. LPA stated the reason for the inspection. LPA observed a family member depart after visiting with a resident in their room. All other residents were resting in their rooms during the inspection. LPA discussed the letter received from the Administrator on April 22, 2026 noting resident (R1) completed treatment for suspected scabies on April 13, 2026. The administrator explained that (R1) moved in on December 31, 2025 and noticed redness in their upper chest area, which is also documented on a skin assessment conducted that day. The Administrator stated that (3) days after (R1) moved in, she spoke to a social worker who suggested (R1) be evaluated by a skin specialist, since they had previously contracted scabies but was cleared prior to move in. The Administrator stated (R1) continued to use the creme they moved in with, but the rash had not improved, so the doctor prescribed a different creme, Permethrin 5% creme, to be applied twice daily, effective 1/25/2026, which was logged on facility records. The Administrator stated (R1) would itch and only had redness on their chest and buttocks; however, the redness/rash did not resemble scabies rash. (R1) went to the emergency room on March 26, 2026 related to their catheter and returned the next day. The Physician's Report (3/27/26) is complete except for regarding any skin conditions. Medication orders (3/27/26) list Permethrin Topical 5% creme to be given twice daily. LPA reviewed medications for (R1), including the creme Triamcinolone Acetonide .1%, that (R1) has been using since on/around January 2026- and has shown no rash since it's been refilled every (2) weeks, instead of monthly. *cont on 809C-1.. 809C-2... (R1) was not awake during today's inspection so LPA was not able to speak to them. The administrator stated (R1) does not currently have a rash, and no other resident ever acquired a similar looking rash. LPA previously conducted an inspection for February 10, 2026 regarding resident (R1) who showed a rash on their chest starting on February 9, 2026. A video appointment was conducted yesterday and (2) prescription creams were prescribed. (R1) began using the first cream in February 9, 2926, and the rash looks much better and is not itchy. A second prescription creme was started on February 10, 2026. The administrator agreed to change laundry detergents for (R1) to see if there was a possible allergy or (R1) has sensitive skin and wash (R1's) laundry separately. LPA and the Administrator discussed resident (R2) and getting them evaluated for a possible Guardian. The administrator stated (R2) has an in-person appointment with their primary care physician in May 2026 and she will discuss this matter and ask the physician to complete a new referral so (R2) can be evaluated again since they did not qualify over a year ago. The facility notified the Department timely of the skin rash and medical appointments made. There are no deficiencies issued in this report. Exit interview. Copy of report provided.the state’s words, verbatim · CDSS document, Apr 23, 2026

Type of visit: Case Management - Other

Licensing Program Analyst (LPA) Sabrina Calzada arrived unannounced to conduct a required annual. LPA met with the Administrator, Vera Okyere. Also present was care staff, Michael Arkoh. LPA observed (1) resident in the common area and (3) residents in their rooms. There is an approved hospice waiver for (4) residents and fire clearance for (6) non-ambulatory residents. There are (0) residents under hospice care. LPA and the administrator discussed how resident (R1) showed a rash on their chest starting on February 9, 2026. A video appointment was conducted yesterday and (2) prescription creams were prescribed. (R1) began using the first cream yesterday and the rash looks much better and is not itchy. A second prescription creme will be started today. (R1) previously had skin rashes that were not contagious; however, the facility has been following their protocols and separating (R1's) laundry, etc. Tomorrow, a home health care nurse will visit (R1) and provide an update on the rash. The administrator will take (R1) to a follow up, in person medical appointment next week after the creams have been applied. (R1) was taking a nap during the inspection so LPA was not able to talk with (R1). LPA and the administrator discussed how resident (R2) may need to be reassessed for a possible Public Guardian. LPA attempted to contact a representative again, during today's inspection, and left a message requesting a return call. The administrator stated she will follow up with (R2's) primary care physician about sending a new referral over. LPA observed (R2) to be resting on the couch in the common area. The administrator stated (R2) has not had any changes in the last month. There are no deficiencies issued in this report. Exit interview. Copy of report provided.the state’s words, verbatim · CDSS document, Feb 10, 2026

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Sabrina Calzada arrived unannounced to conduct a required annual. LPA met with the Administrator, Vera Okyere. Also present was care staff, Michael Arkoh. LPA observed (2) residents in the common area and (2) residents in their rooms. There is an approved hospice waiver for (4) residents and fire clearance for (6) non-ambulatory residents. There are (0) residents under hospice care. LPA and Administrator toured the interior/exterior of the facility including the common areas, (4) private resident bedrooms (1) shared resident bedroom, (2) resident bathrooms, kitchen, activity room, staff room and laundry/storage area. All areas were observed to be clean, in good repair and odor free. Bathrooms have the necessary grab bars, non-skid flooring, hand-washing poster, and a hand dryer. There is sufficient 2+day perishable, including fresh produce, and 7+day non-perishable supply of food. The pantry is well organized and canned food was recently purchased. Sharps and medications are locked in the kitchen and toxins are secured in the laundry area. Inside temperature measured 75*F. The fire extinguisher was last serviced 1/12/2026, and the smoke/monoxide alarms are functioning. There are night-lights throughout. There is sufficient linen, blankets and incontinent and PPE supplies. There is (1) unlocked gate outside, and there are no pools. There are no blockages to exit doors and all doors have alarms. Staff are aware where utility shut off valves are located. The facility just switched to solar power. Required postings viewable. LPA reviewed (2) resident files and (4) staff files. All files were organized and contained required documentation. Medications were reviewed for (1) resident- orders match medications. All staff are cleared/associated and have completed the required annual training within the last (12) months. Administrator RCFE certificate #7013785740 (exp 8/15/27). LPA and the Administrator discussed multiple other topics. LPA requested an updated copy of LIC308, LIC500 and current liability insurance by 1/22/26. There are no citations issued in this report. Exit interview. Copy of report provided.the state’s words, verbatim · CDSS document, Jan 15, 2026

Type of visit: Case Management - Other

Licensing Program Analyst (LPA) Sabrina Calzada arrived unannounced to conduct a required quarterly case management inspection and was greeted by Bright Asante, staff. LPA then met with Vera Okyere, Administrator, and explained purpose of inspection. LPA observed (1) resident in the common area and (3) residents in their rooms at the start of the inspection. The facility is licensed for (6) non-ambulatory residents and has a hospice waiver for (4). Currently, there are (0) residents on hospice. LPA reviewed the binder with printed training certificates for all (4) staff to have been completed for July and August 2025. Training topics varied each month: July- Restricted Health Conditions and Postural Supports; August- Medications and Resident Rights. LPA suggested a summary training page be completed for each staff to ensure the required annual ADL and medication training is completed moving forward. LPA and Administrator toured the inside areas of the facility including the kitchen, bathroom, resident rooms, laundry area. LPA observed the facility to be clean, in good repair and odor free. The main refrigerator contained eggs, yogurt, some produce, and sweet treats, and the spare refrigerator in the pantry area contained several loaves of sandwich bread and milk. The pantry area was well stocked with dry goods such as cereal, apple sauce, peanut butter, pasta, and assorted canned foods. LPA encouraged that staff regularly prepare fruit/vegetable smoothies since some residents have a pureed diet. LPA printed and signed an updated copy of the facility license and obtained the probationary license back that was posted. The three year probationary period was in effect from 8/25/2022- 8/25/2025. There are no citations issued in this report. Exit interview. Copy of report provided.the state’s words, verbatim · CDSS document, Aug 28, 2025

Type of visit: Case Management - Incident

Licensing Program Analyst (LPA) Sabrina Calzada arrived unannounced to conduct a case management inspection and was greeted by Bright Asante, staff. LPA then met with Vera Okyere, Administrator, and explained purpose of inspection. LPA observed (1) resident in the common area and (3) residents in their rooms at the start of the inspection. Currently, there are (0) residents on hospice. LPA and the Administrator discussed a recent incident report where resident (R1) went to the emergency room on 8/23/2025 in the afternoon. The incident report was submitted to the Department on 8/27/2025 and notes resident's speech therapist was present and requested resident be sent to the emergency room after taking resident's vitals and determining they were not normal. The report includes that resident was diagnosed with a Urinary Tract Infection and would be in the hospital for a few days. The Administrator stated (R1) had recently moved in, and the family stated resident would stay for only (3) weeks after being discharged from a skilled nursing following a stroke and surgery. The Administrator stated when she visited the resident in the hospital, on 8/26/2025, she was told (R1) would return the following day. The Administrator stated that (R1) was discharged to a skilled nursing facility on 8/27/2025 where she will remain for a few days and explained (R1) was using a foley catheter. The Administrator stated she told the nurse two days before resident went to the hospital, (R1) wasn't drinking enough water, the nurse said to increase/encourage more water intake, which the facility did. Additionally, (R1) had just finished eating lunch prior to the speech therapist visiting on 8/23/2025. It appears the facility took appropriate action in discussing concerns with the home health nurse. There are no citations issued in this report. Exit interview. Copy of report provided.the state’s words, verbatim · CDSS document, Aug 28, 2025

Type of visit: Case Management - Other

Licensing Program Analyst (LPA) Sabrina Calzada arrived unannounced to conduct a required quarterly case management inspection and met with Bright Asante, staff. LPA then met with Vera Okyere, Administrator, and explained purpose of inspection. LPA observed (1) residents in the common area and (4) residents to be in their rooms at the start of the inspection. The facility is licensed for (6) non-ambulatory residents and has a hospice waiver for (4). Currently, there are (0) residents on hospice. LPA observed (2) home health staff leaving at the start of the inspection and (1) home health staff later arrive during the inspection. LPA reviewed the binder with documentation of monthly training for all (4) staff to have been completed for April to June 2025. Training topics varied each month: Medications and Documentation, Role, Responsibilities and Terminology specific to medication assistance handling medications, pharmacy abbreviation and symbols; and hospice care. LPA and Administrator toured the inside areas of the facility including the kitchen, bathroom, resident rooms, laundry area. LPA observed all areas to be clean and in good repair. LPA observed the main refrigerator to contain several dozen eggs, yogurt, produce, and sweet treats, the spare refrigerator in the pantry area to contain several loaves of sandwich bread and milk and the pantry to contain dry goods such as cereal, peanut butter, pasta, and assorted canned foods. Administrator to complete staff training for July and August 2025 as the probationary period ends on August 25, 2025. LPA to check training records at a subsequent inspection. There are no citations issued in this report. Exit interview. Copy of report provided.the state’s words, verbatim · CDSS document, Jul 3, 2025

Type of visit: Case Management - Other

Licensing Program Analyst (LPA) Sabrina Calzada arrived unannounced to conduct a required quarterly case management inspection. LPA met with Vera Okyere, Administrator, and explained purpose of inspection. LPA observed (2) residents in the common area and (3) residents to be in their rooms at the start of the inspection. The facility is licensed for (6) non-ambulatory residents and has a hospice waiver for (4). Currently, there are (0) residents on hospice. LPA reviewed the binder with documentation of monthly training for all (3-4) staff to have been completed for November 2024 through March 2025. Training topics varied each month: Psychosocial Needs of the Elderly, Nutrition and Exercise, Restricted Health Conditions, Dementia care, and Resident Rights. Administrator agreed to conduct training on Medication Management in April 2025 and in May 2025, if needed. LPA and Administrator toured the inside areas of the facility including the kitchen, bathroom, resident rooms, laundry area and staff rooms. LPA observed all areas to be clean and in good repair. LPA observed the main refrigerator to contain several dozen eggs, yogurt, produce, sweet treats, condiments and the main freezer to be full with a variety of frozen meals, pot pies and chicken nuggets. LPA observed the spare refrigerator in the pantry area to contain several loaves of sandwich bread and milk and the pantry to contain dry goods such as cereal, peanut butter, pasta, and assorted canned foods. LPA advised the Department will conduct a subsequent quarterly visit on/around June 2025. LPA and Administrator also discussed Plan of Corrections outstanding and what is needed still to clear. LPA to follow up and send an email with specifics for clarification. There are no deficiencies cited in this report. Exit interview. Copy of report emailed to Administrator due to technical issues.the state’s words, verbatim · CDSS document, Apr 2, 2025

Allegation investigated: Staff do not provide a sufficient quality of food to resident. Staff do not ensure that resident's incontinence needs are being met. Staff do not ensure that resident's showering needs are being met.

Licensing Program Analyst (LPA) Sabrina Calzada arrived unannounced to deliver findings to a complaint received on November 25, 2024. LPA initially met with staff, Bright Asante, and then shortly met with Administrator, Vera Okyere, and stated the reason for today's inspection. LPA observed (3) residents eating dinner in the common area and (1) resident in resting in her room. During the investigation, LPA interviewed the Administrator, (1) care staff, resident (R1), (3) additional residents, and (2) family members of (R1). The Ombudsman also spoke to (R1) and LPA about the allegations and asked (R1) to take photos of food being served. LPA reviewed documentation related to (R1), including,but not limited to, physician's report, pre-appraisal, and care plan. The physician’s report, dated 11/7/24, states (R1) has a diagnosis of Orthopedic aftercare following surgery, needs assistance with bathing, dressing and toileting, has left side weakness,a history of skin breakdown, is not incontinent, and requires a special diabetic diet that is easy to chew and has no added salt. The physician's report does not note any cognitive functioning deficits for (R1). The results of the investigation are as follows: Substantiated 9099C-1.. Allegation: Staff do not provide a sufficient quality of food to resident. The allegation states (R1) is diabetic, and the facility is not feeding her well. On 11/21/24, (R1) was served a hot dog bun with peanut butter for dinner and on 11/22/24, (R1) was given 2 pieces of bread with cheese sauce for dinner. On 11/26/24, (R1) confirmed that she was served a hot dog bun with peanut butter and then top ramen because she is "always hungry" because they do not give her "enough" food. (R1) stated they sometimes offer her mixed canned veggies, applies, bananas, and raw carrot and broccoli, but a fruit and vegetable are not offered at every meal. The Administrator asserted (R1) "always tells us what she want to eat" and not follow the menu, explaining that for lunch today, staff prepared a grilled cheese sandwich and an apple but (R1) has been requesting "hamburgers, mashed potatoes with gravy, and BBQ chicken". The Administrator added that for Thanksgiving, she has placed an order with a local grocery store for their Thanksgiving meal. A family member stated on 12/20/24 that (R1) called 9-1-1 last week because her blood sugar was low and the facility is not serving good food and that another family member of (R1) brings food to the facility. This family member stated the food served is not good and staff are serving a hot dog bun with nacho sauce inside. (R1) stated staff will take an hour to get her cottage cheese and yogurt that her daughter brought to the care home for her. LPA was provided with photos of (4) meal plates served to (R1) during her stay at the facility. One plate showed a bologna sandwich only; a second plate showed pasta noodles with sauce only; a third plate showed a peanut butter sandwich and two cut orange pieces; a fourth photo showed cold cereal and milk with a few banana pieces. On 1/22/25, LPA observed resident (R2) to be eating a chicken bake with fruit and a drink; (R3) was eating pureed food since returning from the hospital recently, and (R4) was eating a chicken bake. On that day, LPA observed more frozen food than fresh food and frozen food consisted of packages of hot dogs, corn dogs and meatballs. There were about a dozen eggs, some grapes, other produce items in the refrigerator. LPA observed an extra refrigerator in the pantry area to contain hot dog/hamburger buns, milk and lots of pantry items, including pasta, Pop-Tarts, canned food, Cream of Wheat, and Oatmeal. *cont on 9099C-2.. 9099C-2.. Under "Basic Services, the Admission Agreement notes that (R1) will receive: 1- Three nutritious meals daily and snacks and 2- Special diets if prescribed by a doctor. (R1's) physician's report also notes that (R1) requires a special, diabetic diet, low in salt that is "easy to chew". Per Mayo Clinic, a diabetic diet should consist of: Balance carbs with fiber and protein in each meal. This is easy if you use the plate method. Make half of your plate vegetables, a quarter of your plate a carb like brown rice, black beans, or whole-wheat pasta, and the other quarter of your plate a healthy protein like chicken breast, fish, lean meat, or tofu. Administrator stated (R1) refused vegetables as they were "too crunchy" and refused all soups and all breakfast except for Cream of Wheat or Oatmeal. The Administrator stated she called 9-1-1 the time it was low, and emergency staff determined that (R1's) arm sensor to measure blood sugar needed to be replaced. The emergency staff tested (R1's) blood sugar using their own test and it was low but not as low as the sensor indicated. (R1) did not have to be sent out. A family member of (R1) stated there were no snacks served so she brought snacks, such as soup, and (S1) refused to serve them to (R1). A second family member stated that after (R1) had low blood sugar, the family brought over candy covered peanuts, and staff placed them on the other side of (R1's) room so she couldn't reach them. The Administrator stated (R1's) blood sugar was never high and was normal on all days but that one day when the sensor needed replacing. (R1) would regularly talk to her doctor. Based on information obtained during the investigation, the Department find the allegation to be SUBSTANTIATED- A finding that the complaint is Substantiated means that the allegation is valid because the preponderance of the evidence standard has been met. Allegation: Staff do not ensure that resident's incontinence needs are being met. The allegation states (R1) asked for their adult diaper to be changed, and the caregiver will only change (R1) (3) times per day and (R1) is sitting in their urine all day. The Administrator stated on 11/26/24 she told (R1’s) daughter that the facility "doesn't buy briefs" and the family has not brought any briefs over at all since resident moved in on 11/8/24. The Administrator stated staff will change (R1) when the call light is pressed and that (R1) "will push the button frequently, about every hour". The Administrator asserted that (R1) "told staff they have to manage the diapers and can't change her too often", and “the first two weeks when the facility was buying the diapers, (R1) would call every 45 minutes to be changed". *cont on 9099C-3.. 9099C-3.. On 11/26/24, (R1) stated to LPA that she is changed "usually two times per day" and staff "cannot reposition" her, as staff (S1), stated her back hurts and the Administrator or another staff (S3) are needed to assist. On 11/26/24 (3:20 pm) (R1) stated to LPA that staff have changed her diaper twice today, once after breakfast and then again after lunch, and she needs to be changed again now, and "staff will go 4-5 hours sometimes to check me and they only change me at mealtimes". (R1) stated she is "not sure" if NOC staff are awake or on-call and was also "not sure" if the call buttons are working, asserting she pushed her button three times recently and staff, (S1) took 30 minutes to respond, explaining she "was busy with other clients". LPA observed an unopened package of diapers in (R1's) room on 11/26/24. A family member of (R1) stated she was told at move in that the family provides incontinent products and she ensured that there were always diapers available to (R1). She stated she would bring over (2) large packages, every two weeks, and (R1) never ran out. The family member stated that she also later brought over wipes after learned wipes were not being used and (S1), who provided all the care, was still not using them. The Administrator stated that the facility provides wipes and all staff use them. The family member stated that at least (1) night (R1) was sitting in a soiled diaper. Based on information obtained during the investigation, the Department find the allegation to be SUBSTANTIATED- A finding that the complaint is Substantiated means that the allegation is valid because the preponderance of the evidence standard has been met. Allegation: Staff do not ensure that resident's showering needs are being met. The allegation states (R1) has not been bathed for about a week and when (R1) asked for a bath, the caregiver refused to give them one. On 11/26/24, the Administrator explained that she "has been calling home health every other day" to arrange for Physical Therapy to come out but has not heard from Home Health since (R1) moved in, on 11/8/24. The Administrator stated that "two to three times per day, (R1) goes BM all over her bed and we have to clean the sheets", and "every other day, (R1) receives a bed bath". The Administrator agreed to go to speak to the home health social worker the next day, and advised LPA that she had been informed home health was discontinued due to resident’s insurance coverage. *cont on 9099C-4.. 9099C-4... On 11/26/24, (R1) stated she received her "first bath yesterday", which was "brief". A family member stated that (R1) received (2) bed baths during the time she resided at the facility and (S1) gave her the first one and the Administrator gave her the second one, on/around 12/31/24. This family member stated that (S1) "grabbed a cold wash cloth and gave (R1) a quick wipe down". The family member stated that (S1) would not strap (R1's) correctly which may have caused (R1's) bedding to become soiled and need changing frequently. The family member stated that the facility "had all the equipment " to provide the ADL's but didn't and the family was not aware the care was not being done, until about (2) weeks after (R1) moved in and the family was informed they couldn't move (R1). The Administrator informed LPA that (S1) was let go as a employee on/around January 2025. Based on information obtained during the investigation, the Department find the allegation to be SUBSTANTIATED- A finding that the complaint is Substantiated means that the allegation is valid because the preponderance of the evidence standard has been met. Per California Code of Regulations,Title 22, Division 6, Chapter 8, the following (3) deficiencies are being cited on the 9099-D pages. Exit interview. Copy of report and appeal rights provided. 9099A-C-1.. (R2) responded that staff " let me turn them on during the day but I like to sleep with the light off at night". The Administrator stated a resident can leave the lights and television in their room all day and all night and (R1) would keep the television on all night. LPA observed night-lights in the common areas Based on information obtained, LPA finds the allegation to be UNSUBSTANTIATED- a finding that although the allegation may have happened or is valid, there is not a preponderance of evidence to prove that the alleged violations occurred. Allegation: Staff do not ensure that resident is receiving their medication as prescribed. Allegation states (R1) is prescribed an antidepressant medication, Wellbutrin, and staff haven’t administered the medication since (R1) moved in. On 11/26/24, the Administrator stated (R1) moved in with 14 days of medications, but there were "4-5 missing medications", based on the medication list (R1) moved in with, and she let (R1’s) daughter know, a week ago. The Administrator stated she "doesn't know” the medication, Wellbutrin, and the "daughter is handling all the medications". On 11/26/24, (R1) stated she ran out of the antidepressant, Wellbutrin, commenting she thinks the prescription had run out and explained the request for a refill was "just sent in" but she is not sure if it was approved. LPA observed that (11) medications were logged as started on 11/8/24, including at least one medication for diabetes. (R1's) family member stated that (R1) may have not had this medication at the beginning but eventually got the medication filled, confirming she would pick up and deliver all medications to the facility for (R1). Based on information obtained, LPA finds the allegation to be UNSUBSTANTIATED- a finding that although the allegation may have happened or is valid, there is not a preponderance of evidence to prove that the alleged violations occurred. Exit interview. Copy of report provided to Administrator.the state’s words, verbatim · CDSS document, Feb 21, 2025 · control 59-AS-20241125080359

From the deficiency page — Deficiency type: Type B · Section cited: CCR 87555(a) · Plan of correction due date: Mar 7, 2025

87555 General Food Service Requirements (a) The total daily diet shall be of the quality and in the quantity necessary to meet the needs of the residents and shall meet the Recommended Dietary Allowances of the Food and Nutrition Board of the National Research Council. All food shall be selected, stored, prepared and served in a safe and healthful manner. This requirement is not met as evidenced by: Based on interviews conducted and photo documentation, the Licensee did not ensure that (R1) was provided with meals and snacks, as stated in the Admission Agreement and per resident's special diet requirement, per the physician's report, which posed a potential health and safety risk to residents in care.the state’s words, verbatim · CDSS document, Feb 21, 2025

Plan of correction: Licensee/Administrator agree to watch an audio training on nutritious diet, including for diabetes, and submit a menu and snack schedule by 3/7/25.

From the deficiency page — Deficiency type: Type B · Section cited: CCR 87625(b)(2) · Plan of correction due date: Mar 7, 2025

87625 Managed Incontinence (b) In addition to Section 87611, General Requirements for Allowable Health Conditions, the licensee shall be responsible for the following: (2) Ensuring that incontinent residents are checked during those periods of time when they are known to be incontinent, including during the night. This requirement is not met as evidenced by: Based on interviews conducted, the LIcensee did not ensure that (R1) was provided with regular incontinent care during the awake hours and during the night on at least (1) occasion after (R1) had lose stool, which posed a potential health and safety risk to residents in care.the state’s words, verbatim · CDSS document, Feb 21, 2025

Plan of correction: Licensee/Administrator agree to conduct staff training on how/when to document when incontinent care is provided. Submit proof of training and form to be used by 3/7/25. Administrator to submit additional documentation of incontinent changes provided.

From the deficiency page — Deficiency type: Type B · Section cited: CCR 87464(d) · Plan of correction due date: Mar 7, 2025

87464 Basic Services - (d) A facility need not accept a particular resident for care. However, if a facility chooses to accept a particular resident for care, the facility shall be responsible for meeting the resident's needs as identified in the pre-admission appraisal specified in Section 87457, Pre-admission Appraisal and providing the other basic services specified below, either directly or through outside resources. This requirement is not met as evidenced by: Based on interviews conducted, the Licensee did not ensure that (R1) received regular bathing, at least twice weekly, and when needed, which posed a health and safety risk to residents in care.the state’s words, verbatim · CDSS document, Feb 21, 2025

Plan of correction: LIcensee/Administrator agree to start documenting when a shower is given or refused- signed by staff and the resident. Training to be conducted with all staff and Admin to submit documentation of how the showers will be documented by 3/7/25.

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Sabrina Calzada arrived unannounced to conduct a required annual. LPA met with the Administrator, Vera Okyere. Also present was care staff, Charles Zabay. LPA observed (2) residents in the common area and (2) residents to be in their room at the start of the inspection. LPA observed a Physical Therapist arrive to meet with one of the residents and then an Occupational Therapist arrive to meet with another resident. LPA and Administrator toured the interior/exterior of the facility including the common areas, (4) private resident bedrooms (1) shared resident bedroom, (2) resident bathrooms, kitchen, activity room, staff room and laundry/storage area. LPA observed the facility to be clean, in good repair and odor-free, and the bathrooms to have the necessary grab bars, non-skid flooring, paper towels. The Administrator will post 20-second hand-washing posters at each sink. There is sufficient 2+day perishable, including fresh produce and 7+day non-perishable supply of food, Sharps and medications are locked in the kitchen and toxins are secured in the laundry area. Inside temperature measured 72*F. Hot water measured 108*F in a resident bathroom. There is signage in the kitchen cautioning staff the hot water temperature is 125*F or hotter. There is sufficient linen, blankets and incontinent/ PPE supplies. There is (1) unlocked gate outside, screens are in good condition and there is an abundant back yard space. Required postings are up. LPA reviewed (2) resident files and (4) staff files. All files were organized and contain current documentation. Medications were reviewed for (1) resident- there were no errors found and the documentation is complete. All staff are cleared/associated and are completing the required annual training. New staff are in the process of completing the required initial training. All staff have current First Aid/CPR. The Infection Control Plan (27 pgs) was reviewed/approved. LPA requested updated copy of LIC308, LIC500 and current liability insurance.There are no deficiencies observed. The following (2) Technical Advisory Notes were issued. Exit interview. Copy of report provided to the Administrator.the state’s words, verbatim · CDSS document, Jan 22, 2025

Allegation investigated: Staff retaliating against resident.

Licensing Program Analyst (LPA) Sabrina Calzada arrived unannounced to commence a complaint investigation. LPA met with staff, Lydia Awuku, and then Administrator, Vera Okyere, who was also present. LPA observed (3) residents present and a family member visit and take a resident on a short outing. During today's inspection, LPA interviewed the Administrator and resident (R1), who is the subject of the complaint. The results are as follows: The allegation states on November 27, 2024, at about 2 PM, the Administrator verbally informed (R1) that she would be receiving an eviction notice and stated the reason was for filing a complaint with the Department. The Administrator stated she did tell (R1) last week she would give her "a week or more" to move out since she needs assistance from home health to transfer to a wheelchair, and home health has not been started since resident moved to the facility approximately (3) weeks ago. *cont on 9099C-1.. Unsubstantiated 9099C-1... The Administrator stated assistance is needed from home health staff to train facility staff on how to transfer resident from their bed to their wheelchair for meals and bathing, occupational therapy and a nurse to assist with medication, since resident is diabetic. The Administrator stated that she stated the only reason given to the resident for issuing a possible eviction was due to staff not being able to transfer resident from bed, and "never told (R1) that she was evicting (R1) due to filing a compliant" and stated "it's her right- I wouldn't do that". The Administrator stated she also told (R1) that she would be following up with the Department LPA as far as next steps prior to issuing a written notice. LPA received an email on 11/27/24 (2:53 pm) from the Administrator asking for next steps after confirming with a placement specialist (R1) does not qualify for home health services. The Administrator followed up with LPA by phone on 12/4/24 (9:33 am), requesting a call back. The (R1) stated to LPA on 12/4/24 that she was given two reasons for a possible eviction and those reasons are for filing a complaint and because she didn't have in-home health care. (R1) confirmed she was told she had (7) days to move but has not been given a written notice yet. (R1) provided a contact for the placement specialist for additional information. (R1) stated she is able to reposition herself and staff also has been helping to reposition her every 2 hours. LPA and Administrator contacted the placement specialist during today's inspection who confirmed (R1) is eligible for home health services and the prior social worker stopped working at the skilled nursing just after (R1) was discharged. Administrator will follow up in person today with another social worker and/or the Director of Nursing about getting home health started at the care home as soon as possible, since it was never followed through on. The Administrator will not issue a (30) day written eviction notice until it is confirmed with the Director of Nursing or the assigned social worker (R1) is eligible for home health services. LPA advised the Administrator and (R1) that a (30) day eviction notice must be issued for a legal eviction. Based on information obtained, LPA finds the allegation to be UNSUBSTANTIATED- a finding that although the allegation may have happened or is valid, there is not a preponderance of evidence to prove that the alleged violations occurred. Exit interview. Copy of report provided.the state’s words, verbatim · CDSS document, Dec 4, 2024 · control 59-AS-20241127152823

Type of visit: Case Management - Deficiencies

Licensing Program Analyst (LPA) Sabrina Calzada arrived unannounced to conduct a follow up case management inspection and met with Vera Okyere, Administrator. LPA stated the reason for the inspection. There are currently (3) residents who live at the home, but (1) resident went to the hospital last night. Currently there are (0) residents receives hospice care. LPA previously conducted a related case management inspection, on 9/25/24, and discussed resident (R1's) personal property and (R1) being sent to the emergency room on 9/11/24. The Administrator provided documentation related to (R1's) property and receipts for clothing, medication and rent and care charged from 8/26/24- 9/26/24. The Administrator provided additional documentation by e-mail, as requested, on 9/26/24, showing funds belonging to (R1) had been co-mingled with Licensee's funds. Resident's family member removed (R1's) belongings from his room on 9/30/24, and the Administrator mailed a check for personal funds belonging to (R1) on 10/1/24, which was received on 10/3/24. The physician's report indicates (R1) has a diagnosis of Dementia and requires assistance in managing his own cash resources. LPA and Administrator discussed how a surety bond is required in order to handle residents' funds, and the department was not notified. During today's inspection, LPA and Administrator discussed how (R1) did not sign the Admission Agreement when moving in on 8/26/24 and that (R1) was charged for 1:1 care, following being sent to the hospital on 9/11/24, and not returning to the facility, as he passed in the hospital on 9/21/24. LPA requested documentation showing a 1:1 staff was provided to (R1) from 8/26/24 until 9/11/24, when (R1) was sent to the emergency room. Per California Code of Regulations Title 22, Division 6, Chapter 8, the following (4) deficiencies are issued on the 809-D pages, as well as a Technical Advisory Note. Exit interview. Copy of report and appeal rights provided.the state’s words, verbatim · CDSS document, Nov 14, 2024

From the deficiency page — Deficiency type: Type A · Section cited: CCR 87217(e) · Plan of correction due date: Nov 29, 2024

87217 Safeguards for Resident Cash, Personal Property, and Valuables. (e) Cash resources and valuables of residents which are handled by the licensee for safekeeping shall not be commingled with or used as the facility funds or petty cash, and shall be separate, intact and free from any liability the licensee incurs in the use of his own or the facility's funds and valuables. This does not prohibit the licensee from providing advances or loans to residents from facility money. This requirement is not met as evidenced by: Based on interviews conducted and documentation reviewed, including bank documentation, the Licensee did not ensure that (R1's) personal funds were not comingled with the Licensee's funds, as they were deposited into an account belonging to the Licensee on 8/27/24, which posed an immediate health and safety risk to residents in care.the state’s words, verbatim · CDSS document, Nov 14, 2024

Plan of correction: The Administrator issued a check to (R1's) responsible person for funds belonging to (R1) on/around 10/1/24, following (R1's) passing on 9/21/24. The Administrator agrees to read Regularion 87217 and submit a statement in writing that it is understood by 11/29/24. ,

From the deficiency page — Deficiency type: Type B · Section cited: CCR87507(f) · Plan of correction due date: Dec 2, 2024

87507 Admission Agreements (f) The licensee shall comply with all applicable terms and conditions set forth in the admission agreement, including all modifications and attachments. This requirement is not met as evidenced by: Based on interviews conducted and documentation reviewed, the Licensee did not comply with providing 1:1 care, as charged, for the period, 9/12/24- 9/26/24, as (R1) was sent to the emergency room on 9/11/24 and did not return to the facility as (R1) passed in the hospital on 9/21/24, which posed a potential health and safety risk to residents in care.the state’s words, verbatim · CDSS document, Nov 14, 2024

Plan of correction: The Licensee agrees to refund the portion charged for 1:1 care, from 9/12/24 to 9/26/24, to (R1's) family member. Will issue refund to (R1's) family member by 12/2/24.

From the deficiency page — Deficiency type: Type B · Section cited: CCR 87507(c) · Plan of correction due date: Nov 29, 2024

87507 Admission Agreements. (c) Admission agreements shall be signed and dated, acknowledging the contents of the document, by the resident or the resident’s representative, if any, and the licensee or the licensee’s designated representative no later than seven days following admission. Attachments to the agreement may be utilized as long as they are also signed and dated as prescribed above. This requirement is not met as evidenced by: Based on documentation review, the Licensee did not ensure the Admission Agreement was signed by (R1) and/or the responsible person, which posed a potential health and safety and/or personal rights risk to residents in care. (R1) was not conserved, did not have a legal responsible person and had a diagnosis of Dementia. Administrator stated you told (R1) the amount of rent being charged because (R1) refused to sign.the state’s words, verbatim · CDSS document, Nov 14, 2024

Plan of correction: Licensee agrees to ensure all current/future Admission Agreements have been/will be signed by the resident, or responsible person. Admin agrees to submit a signed statement that all agreements have at least 2 signatures and Reg 87507 is read and understood- submit by 11/28/24. .

From the deficiency page — Deficiency type: Type B · Section cited: CCR87216(d) · Plan of correction due date: Nov 29, 2024

87216 Bonding (d) No licensee shall either handle money of a resident or handle amounts greater than those stated in the affidavit submitted by him or for which his bond is on file without first notifying the licensing agency and filing a new or revised bond as required by the licensing agency. This requirement is not met as evidenced by: Based on an interview with the Administrator, the Licensee did not ensure that the Department was notified and a bond was filed for, before handling (R1's) personal funds, which posed a potential health and safety and/or personal rights risk to the clients in care.the state’s words, verbatim · CDSS document, Nov 14, 2024

Plan of correction: Licensee agrees to read Regulation 87216 and submit a signed statement of its understanding by 11/28/24.

Type of visit: Case Management - Other

Licensing Program Analyst (LPA) Sabrina Calzada arrived unannounced to conduct a required quarterly case management inspection. LPA met with Vera Okyere, Administrator, and explained purpose of inspection. Also present was Lydia Awuku, caregiver. LPA observed (0) residents in the common area and (3) residents to be in their rooms at the start of the inspection. The facility is licensed for (6) non-ambulatory residents and has a hospice waiver for (4). Currently, there are (2) residents present, (1) resident in the hospital and (0) residents on hospice. LPA reviewed the binder with documentation of monthly training for all (3) staff to have been completed for April thru October, 2024. Training topics varied each month: Dementia care, postural supports, Aging Process, Importance of Personal Care, Psychosocial Needs of the Elderly, and Nutrition and Exercise. LPA and Administrator toured the inside areas of the facility including kitchen, bathroom, resident rooms, laundry area and staff rooms. LPA observed all areas to be clean and in good repair. LPA advised the Department will conduct a subsequent quarterly visit on/around February 2025. There are no deficiencies cited in this report. Exit interview. Copy of report provided to Administrator.the state’s words, verbatim · CDSS document, Nov 14, 2024

Type of visit: Case Management - Other

Licensing Program Analysts (LPA) Sabrina Calzada and Todd Tryon arrived unannounced to conduct a case management inspection. LPA's met with Vera Okyere, Administrator, and explained purpose of inspection. There are currently (4) residents who live at the home and (1) resident receives hospice care. Also present was Lydia Awuku, caregiver. LPA's observed (1) resident watching television in the common area and another resident return to the facility. There were (2) residents resting in their rooms. LPA's discussed resident (R1) who moved to the facility on/around 8/26/24 and was sent to the emergency room on 9/11/24. (R1) remained in the hospital until 9/21/24, where they passed. LPA's obtained copies of paperwork from (R1's) file. LPA's discussed if an incident report was submitted to the Department within (7) days of (R1) being sent to the emergency room and admitted. LPA's were provided with a copy of the completed incident report and fax receipt showing it was faxed to the Department on 9/14/24 (4:03 am). LPA's toured the facility and observed it to be clean, safe and in good repair. LPA's observed (R1's) wallet and contents. Photos were taken. LPA's discussed providing the Department with additional documentation relating to (R1's) property by 9/26/24. Administrator agreed to submit a completed death report (LIC624A) to the Department by 9/28/24. There are no deficiencies issued in this report. Exit interview. Copy of report provided.the state’s words, verbatim · CDSS document, Sep 25, 2024

Type of visit: Case Management - Other

Licensing Program Analyst (LPA) Sabrina Calzada arrived unannounced to conduct a required quarterly case management inspection. LPA met with Vera Okyere, Administrator, and explained purpose of inspection. Also present was Enock Yartey, caregiver. LPA observed (2) residents in the common area and (3) residents to be in their rooms at the start of the inspection. The facility is licensed for (6) non-ambulatory residents and has a hospice waiver for (4). Currently, there are (5) residents and (1) resident is on hospice. LPA reviewed the binder with documentation of monthly training for all (3) staff to have been completed for December, 2023 and January, February, March 2024. Training topics varied each month. In December 2023, staff received training on hospice and nutrition and exercise. Resident Rights and Medication Role, Responsibilities and Terminology was discussed. In February, Psychosocial needs of the elderly and Recognizing signs and symptoms of Dementia was discussed. Dementia Care and Nutrition and Exercise was discussed in March 2024. LPA also reviewed paperwork for new staff present. Staff is cleared and associated and has current First Aid/CPR and has completed additional required training. As part of the annual inspection, LPA and Administrator toured the inside areas of the facility including kitchen, bathroom, resident rooms, laundry area and staff rooms. LPA observed all areas to be clean and in good repair. LPA observed toxins, medications and sharps to be locked separately in the kitchen and laundry area. LPA observed sufficient food supplies on site, including fresh produce. LPA advised the Department will conduct a subsequent quarterly visit on/around June 2024. There are no deficiencies cited in this report. Exit interview. Copy of report provided to Administrator.the state’s words, verbatim · CDSS document, Mar 26, 2024

Type of visit: Case Management - Other

Licensing Program Analyst (LPA) Sabrina Calzada arrived unannounced to conduct a case management inspection to follow up on recent hospitalization stays for resident (R1). LPA met with Vera Okyere, Administrator, and explained purpose of inspection. Also present was Enock Yartey, caregiver. LPA observed (2) residents in the common area and (3) residents to be in their rooms at the start of the inspection. The facility is licensed for (6) non-ambulatory residents and has a hospice waiver for (4). Currently, there are (5) residents and (1) resident is on hospice. LPA and Administrator discussed the recent hospitalization stays for resident (R1), beginning on/around December 2023 with the last stay ending on 3/20/24. LPA reviewed discharge paperwork which noted resident was prescribed an antibiotic and has a follow up phone appointment on 3/27/24 with his physician. Additionally, (R1) will be receiving home health services for a 2-3 weeks to provide additional care and support. An updated physician's report was obtained on 3/14/24. Administrator will update the care plan to include home health plans. Administrator noted there have been no changes in the level or type of care and resident remains independent. While the Administrator was present, (R1) told LPA he remained in the hospital for a longer period due to being poisoned from the medication the hospital gave him. The Administrator stated the hospital was giving resident the medication, Lithium, three time daily and now the dosage has been lowered to once daily, in the evening only. (R1) stated he has a wound that hasn't healed well and confirmed he will be receiving services from home health. (R1) stated he is eating well now and is happy to be back at the community. LPA reviewed paperwork for (R1) and obtained copies of hospital discharge paperwork. Several incidents reports were submitted during the time frame reviewed. There are no deficiencies cited on this report. Exit interview. Copy of report provided to Administrator.the state’s words, verbatim · CDSS document, Mar 26, 2024

Type of visit: Case Management - Incident

Licensing Program Analyst (LPA) Sabrina Calzada arrived unannounced to conduct a case management inspection following receipt of an incident report that was submitted to the Department on 1/11/24. LPA met with caregiver, Annastaycia Kelly, who informed LPA the Administrator, Vera Okyere, was not present at the facility currently. LPA stated reason for the inspection was to follow up on resident (R1) being sent to the emergency room on 1/6/24. The incident report states that (R1) was unable to sit up by himself, trembling and not taking food and medications so was sent to the emergency room. LPA was instructed by the caregiver to contact the Administrator's spouse by phone. LPA spoke to Steven Doe who explained that the Administrator currently had an emergency and is not able to talk to LPA right now. Steven provided an update on (R1) stating he remains hospitalized due to being confused and non-responsive and is currently in the Intensive Care Unit (ICU). Steven stated he and the Administrator have been trying to contact (R1's) next of kin and have not been able to so far.Steven stated (R1) became weaker and weaker, prior to being admitted to the hospital on 1/6/24, confirming resident did not test positive for Covid. LPA stated she would leave a copy of today's report with the caregiver and asked that the Administrator contact LPA as soon as possible with an update on (R1's) situation. LPA discussed (R1's) condition with caregiver, Annaastaycia, as she was present on 1/6/24 and the days leading up to (R1) being sent out to the emergency room. LPA reviewed (R1's) file and obtained a copy of when (R1) was seen in the emergency room on 12/26/23. Paperwork was not seen for other recent days when (R1) was seen in the emergency room. LPA toured the facility and observed (4) residents present- (1) in the common area finishing lunch and (3) in their resident rooms. LPA observed to be clean, safe and not pose any personal rights violations. There are no deficiencies issued in this report. Exit interview. Copy of report provided to caregiver.the state’s words, verbatim · CDSS document, Jan 19, 2024

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Sabrina Calzada arrived unannounced to conduct a required annual. LPA met with Annastaycia Kelly, caregiver, who contacted Vera Okyere, Administrator. LPA spoke to the Administrator and explained the purpose of today's inspection. Administrator stated she was at the hospital currently with a resident and would arrive shortly. Administrator and resident arrived at 12:40 pm. LPA observed (3) of (4) residents present in the common areas and (1) resident remained in his room during for inspection.The facility is licensed for (6) non-ambulatory residents. (1) resident is on hospice. LPA and Administrator toured the interior/exterior of the facility including the common areas, (4) private resident bedrooms (1) shared resident bedroom, (2) resident bathrooms, kitchen, staff room and laundry/storage area. LPA observed the facility to be clean, in good repair and odor-free. LPA observed the bathrooms to have the necessary grab bars, non-skid flooring, electronic paper towel dispenser and 20-second hand-washing posters. LPA observed sufficient 2+day perishable, including fresh produce and salad mixes, and 7+day non-perishable supply of food, Sharps and medications are locked in the kitchen and toxins are secured in the laundry area. Inside temperature measured 70*F. Fire extinguisher was last serviced 12/12/22- will be serviced again by 12/12/23. Hot water measured 108*F in a guest bathroom but measured 140*F in the kitchen. Administrator to post a sign by the kitchen sink. There are birds and fish in the common area. LPA observed sufficient linen, blankets and incontinent/ PPE supplies on hand. Administrator certificate #6044860740--exp 8/14/23 is pending renewal and was submitted timely to the Department. There is (1) unlocked gate from the inside back patio and no bodies of water. Required postings are up. Administrator to ensure that (30) Personal rights are posted and visible. LPA reviewed (2) resident files and observed them to be organized and contain required/current documentation. Medications were reviewed for (2) residents. Orders were compared to medications being given and no discrepancies were noted. Medication documentation is complete. LPA reviewed (3) staff files. Staff regularly receive ongoing training, and new staff have begun initial training. First Aid/CPR is current. All staff are cleared/associated and roster was recently updated and sent to the Dept. LPA requested updated copy of LIC308, LIC500 and current liability insurance. LPA to provide LIC9282 for Administrator to complete/return by 12/8/23. There are no deficiencies issued but there is a Technical Advisory Note being issued. Exit interview. Copy of report provided.the state’s words, verbatim · CDSS document, Dec 6, 2023

Type of visit: Case Management - Other

Licensing Program Analyst (LPA) Sabrina Calzada arrived unannounced to conduct a required quarterly case management inspection and annual inspection. LPA met with Vera Okyere, Administrator, and explained purpose of inspection. Also present was Annastaycia Kelly, caregiver. LPA observed (1) resident to be in the common area and (3) residents to be in their rooms at the start of the inspection. The facility is licensed for (6) non-ambulatory residents and has a hospice waiver for (4). Currently, there are (4) residents and (1) resident is on hospice. LPA reviewed the binder with documentation of monthly training for all (3) staff to have been completed for September, October, November 2023. Some training has also been started for December 2023. Training topics varied each month. Postural Supports and Dementia related topics were discussed in September 2023. Restricted health conditions were discussed in October 2023 and Postural Supports and Psychosocial needs of the elderly in November 2023. In December 2023, staff received training on hospice and nutrition and exercise. As part of the annual inspection, LPA and Administrator toured the inside areas of the facility including kitchen, bathroom, resident rooms, laundry area and staff rooms. LPA observed all areas to be clean and in good repair. LPA observed toxins, medications and sharps to be locked separately in the kitchen and laundry area. LPA observed sufficient food supplies on site, including fresh produce. Medications, including orders and documentation, were reviewed for (2) residents during today's annual. The facility is maintaining complete records and obtains current orders for residents at each doctor's visit. LPA advised the Department will conduct a subsequent quarterly visit on/around March 2024. There are no deficiencies cited in this report. Exit interview. Copy of report provided to Administrator.the state’s words, verbatim · CDSS document, Dec 6, 2023