Nadia's Care Home

Type of visit: Required - 1 Year

LPA Melissa Parks arrived on Thursday February 23, 2023 to conduct the annual inspection. Prior to the visit, LPA completed required COVID-19 testing protocols, and a daily self-screening questionnaire for symptoms of COVID-19 infection to affirm no COVID-19 related symptoms; LPA ensured they applied hand sanitizer before entering the facility and the following Personal Protective Equipment (PPE) was worn: surgical mask. LPA and Licensee toured the facility together to ensure health and safety of residents in care. In the areas toured, no immediate health, safety, or personal rights violations were observed. LPA and Licensee completed the infection control domain together and facility was found to be in substantial compliance at this time. No deficiencies are being cited as a result of todays inspection. Exit interview conducted. A copy of this report was left at the facility.the state’s words, verbatim · CDSS document, Feb 23, 2023

Type of visit: Case Management - Incident

LPA Parks arrived on Thursday February 23, 2023 to conduct a case management visit. Prior to the visit, LPA completed required COVID-19 testing protocols, and a daily self-screening questionnaire for symptoms of COVID-19 infection to affirm no COVID-19 related symptoms; LPA ensured she applied hand sanitizer before entering the facility and the following Personal Protective Equipment (PPE) was worn: surgical mask. This is a follow up visit for an incident that occurred on 2/18/2023. As R1 was sitting in their recliner, R1 then attempted to stand up independently and fell on the floor. R1 was transferred to the bed where the Licensee did a body exam. No pain, bruising, or skin tears were observed. Later, R1 complained of pain around the right hip. Hospice and DPOA were called. 911 was called and R1 was transferred to the hospital where they were diagnosed with a hip fracture. LPA interviewed S1 and Licensee who were present during the incident. LPA obtained the following documents: R1's physicians report, care plan, and current medication list. No deficiencies were cited. Exit interview conducted.the state’s words, verbatim · CDSS document, Feb 23, 2023

Allegation investigated: Illegal Eviction

LPA Parks arrived on September 26, 2022 date to conclude a complaint investigation regarding the allegation ‘illegal eviction’. Prior to the visit, LPA completed the required COVID-19 testing protocols and a daily self-screening questionnaire for symptoms of COVID-19 infection to affirm no COVID-19 related symptoms; LPA ensured she applied hand sanitizer before entering the facility and the following Personal Protective Equipment (PPE) was worn: N-95 mask. Throughout the course of investigation, LPA interviewed staff and relevant parties. Additionally, LPA reviewed text messages and call logs between POA and Administrator. LPA conducted a review of resident’s file at the facility. LPA was unable to provide evidence that the Administrator evicted resident. Based on information obtained during the investigation, LPA finds the allegation to be UNSUBSTANTIATED- a finding that the complaint is unsubstantiated means that although the allegation may have happened or is valid, there is not a preponderance of evidence to prove that the alleged violation occurred. Exit interview conducted. A copy of this report was left at the facility. Unsubstantiatedthe state’s words, verbatim · CDSS document, Sep 26, 2022 · control 25-AS-20220824092232

The state marks this report as 3 pages; the online copy we transcribed has 1. You can request the full file from the county licensing office.

Type of visit: Prelicensing

Licensing Program Analyst (LPA) Sarena Keosavang arrived at the facility on 3/9/2022 to conduct a Pre-Licensing inspection. LPA met with Administrator, Nadejda Murgoi. Prior to initiating the Pre-Licensing inspection, LPA completed required COVID-19 testing protocols, and a daily self-screening questionnaire for symptoms of COVID-19 infection to affirm no COVID-19 related symptoms and LPA completed a facility risk assessment at the facility. LPA ensured they applied hand sanitizer before entering the facility and the following Personal Protective Equipment (PPE) was worn: Surgical Mask. Additionally, LPA were screened by Administrator upon entering the facility. This is a change in ownership and currently has six (6) residents living in the facility. LPA toured the facility with Administrator. The indoor and outdoor passageways were free of obstruction. The facility has a total of six (6) bedrooms and two (3) and half bathrooms. One bedroom is being used as staff's room. There is an exit in bedroom number two (2), four (4), and six (6) that leads to the backyard. LPA notified Administrator that no locks are permitted on bedroom number three (3) four (4), and six (6). A door alarm is to be set up in the bedrooms with an exit to the backyard for Dementia residents. LPA observed common areas such as: living room, kitchen, residents' bedrooms, bathrooms, laundry room, and backyard. LPA observed knives/sharps were locked in the kitchen pantry. LPA observed toxic and cleaning supplies locked underneath the kitchen sink. LPA observed the require furniture, and lighting throughout the facility. Bathrooms are clean, sanitary, and in good repair. Hot water temperature was measured in residents' bathroom at 119 degrees Fahrenheit. First aid kit was completed with bandages, tweezers, scissors, and thermometer located in the kitchen cabinet. LPA observed centrally stored medication to be locked. LPA observed one (1) fire extinguisher in the kitchen mounted on wall. LPA observed fire detectors and carbon monoxide. Component III presentation conducted with Administrator. LPA observed that the facility is ready to be licensed. This report will be submitted to the Centralized Application Bureau (CAB) and final review of the application will be conducted. This facility is not yet licensed and is subject to final approval by CAB. Additional requirements may still be required. An exit interview was conducted and a copy of this report will be provided to the facility via email.the state’s words, verbatim · CDSS document, Mar 9, 2022

Type of visit: Office

Facility Type: RCFE Application Type: CHOW Capacity: 6 Census (if any clients in care): 6 COMP II Participants: Murgoi, Nadeja (Administrator & Corporate Board Member) Interview Method: Telephone interview On 2/8/22, applicant/administrator participated in COMP II. Identification of the applicant and administrator was verified through interview questions based on photo ID and other identifying personal information. During COMP II, applicant and administrator confirmed the understanding of the California Code Title 22 Regulations. Signed LIC 809 with copy of photo ID have been obtained. During COMP II, CAB analyst confirmed Applicant/Administrator’s understanding of following areas: 1. Facility operation: License type, client/resident populations, and program 2. Admission Policies 3. Staffing requirements & Training 4. Restrictive/Prohibited Health Conditions 5. General provisions 6. Emergency Preparedness 7. Complaints & Reporting 8. Pre-licensing readinessthe state’s words, verbatim · CDSS document, Feb 8, 2022