Ohana Care Home

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Sabrina Calzada arrived unannounced to conduct a required annual and met with staff, Annette Cotterell and Alexa Mititi. Administrator, Dan Mititi, arrived shortly. LPA observed (1) resident in the common area, (2) residents in their rooms at the start of the inspection, and a fourth resident move in during the inspection. The facility is licensed for (6) non-ambulatory residents and has a hospice waiver for (3). Currently, there is (1) resident 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, (1) staff room, kitchen, laundry area, and office. 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 and hygiene supplies. There is sufficient 2+ day perishable and 7+ day non-perishable supply of food. Sharps are locked in the kitchen, and medications and toxins are secured nearby. The inside temperature measured 72*F, and the hot water temperature measured 105.3*F in the kitchen. Disaster drills are conducted every two months, and the type/time of drill is varied. Smoke/monoxide alarms are working. Fire extinguisher last serviced 10/15/2025. There are sufficient towels/linens/blankets. Required postings are visible in the common area. There is (1) unlocked gate, covered patio seating, and the pool is locked/gated. Updated copy of liability insurance obtained. ` LPA reviewed (2) resident files and (3) staff files. Files were organized and complete with current documentation, including required staff training. Staff to begin their ongoing required annual training this month. Administrator RCFE #700176270 (exp 11/10/27). Medications were reviewed for (2) residents- orders were very current and matched medications being administered. Annual fees were paid recently. There are no deficiencies issued in this report. Exit interview. Copy of report provided.the state’s words, verbatim · CDSS document, Apr 10, 2026

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Sabrina Calzada arrived unannounced to conduct a required annual and met with Dan Mititi, Administrator. Caregiver, Annette C. was also present. LPA observed (1) resident in the common area and (2) 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 (3). Currently, there is (1) resident 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, (1) staff room, kitchen, laundry area, and office 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 and hand-washing posters. There is sufficient 2+ day perishable and 7+ day non-perishable supply of food. Sharps are locked in the kitchen, medications are locked in the office area, and toxins are locked in the laundry area. The inside temperature measured 73*F, and the hot water temperature measured 115*F in the kitchen. Facility conducts fire drills every two months- will vary type/time of drill. Smoke/monoxide alarms are working. Fire extinguisher last serviced 10/11/24. There are sufficient towels/linens/PPE/paper products and a complete First Aid kit.. Facility license and other required postings are in the common area- Resident Rights and Rights of Resident/Family Councils posted in the common area. There is (1) unlocked gate, covered patio seating, and an empty pool that is locked/gated. LPA reviewed (3) resident files and (3) staff files. Files were organized and complete with current documentation, including required training. Administrator RCFE certificate is current through 11/10/25. Medications were reviewed for (1) resident- orders matched medications being administered and documentation is current. Discussed Guardian/staff updates. Discussed recent regulation changes and updated Dementia Plan of Operation. Liability insurance is current. There are no deficiencies issued in this report. Exit interview. Copy of report provided.the state’s words, verbatim · CDSS document, May 20, 2025

Allegation investigated: Uncleared staff working in the facility.

Licensing Program Analyst (LPA) Sabrina Calzada arrived unannounced to open and close a complaint received on 12/31/24. LPA met with Dan Mititi, Administator, and explained the reason for the inspection. Also present was staff (S1) who on duty. Currently there are (3) residents on hospice. LPA and Administrator toured the interior to observe residents in care. There were no concerns noted. LPA and Administrator discussed the allegation staff (S2) not being cleared before starting to work at the facility. Documentation showed staff (S1) was cleared and associated to the facility on 6/16/23; (S2) was cleared and associated to the facility on 6/16/23 and worked unitl on/around 7/8/24 and was disassociated. (S3) was cleared and associated on 8/12/23. Review of the LIC500 and Guardian show all current staff are cleared and associated currently to the care home. Administrator confirmed all of this information in today's inspection. Based on information obtained, LPA finds the allegation to be UNFOUNDED- meaning that the allegation was false, could not have happened and/or is without reasonable basis. This allegation is being dismissed without further investigation. Exit interview. Copy of report provided. Unfoundedthe state’s words, verbatim · CDSS document, Jan 2, 2025 · control 59-AS-20241231115538

Allegation investigated: Staff is physically abusing resident. Staff are not providing adequate food service to residents. Staff are locking residents in their rooms. Staff are inappropriately administering sleeping aids to residents.

Licensing Program Analyst (LPA) Sabrina Calzada arrived unannounced to conclude the investigation and deliver findings for a complaint received on August 13, 2024. LPA met with Dan Mititi, Administrator, and stated the reason for today's inspection. State Investigator, Rosemary Chavez, accompanied LPA to observe today's inspection. LPA observed (2) residents awake in the common area and (2) residents resting in their rooms. LPA was informed there are currently (3) residents under hospice care and observed a hospice nurse and chaplain arrive during the inspection. During the course of the investigation, the Department interviewed the Administrator, a hospice nurse, Chaplain, and social worker; (3) family members, and (3) residents. Medication lists were reviewed for each resident (R1-R4) who resided at the care home when the complaint was received. The facility's food supply and resident door handles were observed on 8/14/24 and on 11/12/24. Resident's ankles were observed with the Administrator and the hospice nurse present on 11/12/24. The results of the investigation is as follows: Unfounded 9099C-1.. Allegation: Staff is physically abusing resident. The allegation states that staff (S1) hurts resident (R1's) ankles. No other details were provided. Resident (R1) was not able to be interviewed on 8/14/24 or on 11/12/24, due to moving from the facility for financial reasons on/around 9/30/24. LPA reviewed hospice paperwork, dated 8/5/24, that resident had been admitted for late affects of a stroke. LPA was not able to speak to (R1's) family member after two attempts. LPA spoke to a hospice chaplain, on 11/12/24, while he was visiting the facility. The chaplain stated (R1) was under hospice care while she lived at the facility, and he spoke to her on several occasions. The chaplain indicated (R1) was "really disconnected from reality" when she lived at the facility and was in the process of having her medications adjusted to help prevent hallucinations. The chaplain indicated he actually spoke to (R1) yesterday, 11/11/24, when visiting a skilled nursing facility, and (R1) seems better and was "very coherent" and misses living at the facility. LPA observed the chaplain to speak to (3) current residents (R2, R3 and R5), who are under hospice care during today's inspection. The chaplain indicated he has never observed any residents to appear abused in any way, has no concerns, and residents are "well taken care of". LPA and the Administrator observed residents' ankles on 11/12/24 for residents (R2, R3 and R4). LPA did not observe any bruising on any of the residents. LPA spoke with a hospice nurse in person, on 11/12/24, who indicated she has been attending to these (3) residents for months and she is a mandated reporter, and she has not seen any abuse at the facility. The nurse explained that resident (R3) has edema on their legs instead of bruising and (R3) and the other residents are well taken care of, and the Administrator provides a lot of collaboration with the hospice agency. A hospice social worker indicated that she has "no concerns regarding the care at the facility" and other hospice staff have "not observed any issues of concern". Based on information obtained, LPA finds the allegation to be UNFOUNDED- meaning that the allegation was false, could not have happened and/or is without reasonable basis. Allegation: Staff are not providing adequate food service to residents. The allegation states that residents are not fed enough and are given Jell-O, Pepsi, and water. A hospice social worker stated she has "seen snacks, meals and drinks available to residents" when visiting the facility. One family member of a resident stated she visits regularly and has never seen the facility serve Jell-O, or Pepsi, and the food is wonderful. Another resident's family member stated the facility serves balanced meals, the food looks delicious, and his relative has been gaining weight since moving in. *cont on 9099C-2... *9099C-2... A third resident's family member stated she is not aware of Jell-O being served but her relative likes sweets and the facility provided a special meal for her relative's birthday, as requested. The Administrator indicated the facility does not serve Jell-O, but serves pudding, and Pepsi was only served to (R1), who requested it. A hospice nurse stated she has seen good meals, including breakfast and lunch, when she visits, and snacks available all the time. The facility's food supply was observed on 8/14/24 and on 11/12/24. Both the main refrigerator and spare refrigerator contained the required 2+ days of perishable food, including fresh produce. The pantry displayed 7+ days of non-perishable food on hand, and there is a snack cart with snack food and water in the dining area. LPA observed a hot lunch being served on 11/12/24 which included soup, cracker, a grilled cheese sandwich, and pudding. Based on information obtained, LPA finds the allegation to be UNFOUNDED- meaning that the allegation was false, could not have happened and/or is without reasonable basis. Allegation: Staff are locking residents in their rooms. The allegation states that residents doors are locked at night and the staff can’t go check on them. Resident doors handles were observed on 8/14/24 and on 11/12/24 and were not observed to have a locking mechanism. Photos were taken on 8/14/24. The Administrator confirmed resident doors are never locked and residents are checked every 2-3 hours during the night time shift to ensure they are properly rotated and for incontinent care. The Administrator indicated residents can call for assistance using a call button. Residents who were able to be interviewed indicated they receive assistance when it's requested. Family members who were interviewed indicated they have not noticed if resident doors have a locking mechanism on them. The hospice chaplain, nurse and social worker all indicated that residents are well taken care of, and they do not have any concerns of residents being neglected. Based on information obtained, LPA finds the allegation to be UNFOUNDED- meaning that the allegation was false, could not have happened and/or is without reasonable basis. *cont on 9099C-3... 9099C-3... Allegation: Staff are inappropriately administering sleeping aids to residents. The allegation states that residents are given sleeping medication, so they sleep all day. The Administrator indicated residents are only given medications that are prescribed. A resident's family member stated residents are always active and awake when visiting the facility, and the facility is a nice place to live. Another resident's family member stated their family member is always awake when visiting. A hospice nurse indicated that residents' vitals would be indicative if residents were being given sleep medication(s). The nurse indicated that the residents she visits have consistent vitals and provided vitals for (R2) and (R3) today as 128/84 and 132/89, and stated (R5) takes sedative medications due to behaviors and provided vitals of 98/63 today. Administrator stated (R5) still have severe emotional anxiety, but the hospice medications are helping greatly. (R5) is being monitored by hospice nurses and staff 5 times weekly. The nurse stated she visits the facility once a week and a second nurse visits weekly as well, and asserted she has "never seen any abuse and would report it if I did". The chaplain stated to LPA on 11/12/24 that he has no concerns with (R2) and (R3). LPA observed residents (R2), (R3) and (R4) to be awake during most of today's inspection. LPA was able to briefly communicate with (R5) who was resting and listening to basketball. Based on information obtained, LPA finds the allegation to be UNFOUNDED- meaning that the allegation was false, could not have happened and/or is without reasonable basis. There are no citations issued in this report and the allegations are being dismissed. Exit interview. Copy of report provided to the Administrator.the state’s words, verbatim · CDSS document, Nov 12, 2024 · control 59-AS-20240813143012

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Sabrina Calzada arrived unannounced to conduct a required annual and met with Dan Mititi, Administrator. Caregiver, Harlene Henry was also present. LPA observed all (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 (3). Currently, there is (1) resident on hospice. LPA and Administrator toured the interior and exterior of the facility including the common areas, (4) private resident bedrooms (1) shared resident bedroom, (2) resident bathrooms, (1) staff room, kitchen, laundry area, and office 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, paper towels and hand-washing posters. There is sufficient 2+ day perishable and 7+ day non-perishable supply of food. Sharps are locked in the kitchen, medications are locked in the office area, and toxins are locked in the outside laundry area. The inside temperature measured 71*F, and the hot water temperature measured 106*F in the kitchen. Facility conducts quarterly fire drills. Smoke/monoxide alarms are working. Fire extinguisher was last serviced 10/23/2023. There are sufficient towels/linens/PPE/paper and incontinent products. All required postings are in the common area. LPA observed (1) unlocked gate from the outside patio and also covered patio seating. There is an empty pool that is locked and gated.First aid kit is complete. LPA reviewed/approved the Infection Control Plan and found it complete. Emergency Disaster Plan was also reviewed. LPA reviewed (3) resident files and found them to be complete with current physician's reports and care plans. Medications were reviewed for (2) residents and orders matched medications being administered. Medication documentation is current and PRN dosages are being recorded. LPA reviewed (3) of (3) staff files, which were organized and complete. Current training documentation, including First Aid/CPR, was on file. All staff are cleared and associated to the facility. Discussed Guardian updates to manage roster. RCFE Administrator certificate #6006514740 is pending renewal. LPA obtained an updated copy of the LIC308, LIC500, and current of liability insurance. There are no deficiencies issued during today's inspection. Exit interview. Copy of report provided.the state’s words, verbatim · CDSS document, Apr 8, 2024

Allegation investigated: Facility is violating resident's personal rights by not allowing visitors

On 11/1/23, Licensing Program Analyst (LPA) Kevin Mknelly spoke to Administrator, to deliver complaint findings for the above allegation. LPAs, Kevin Mknelly and Sabrina Calzada, reviewed resident records, facility records and conducted extensive interviews. LPA finds that the allegations cited above are substantiated. R1 was admitted on 8/5/23 and discharged on 8/20/23. R1 was diagnosed with physical, cognitive and communication disabilities. R1 documents review found R1 had a Advanced Healthcare Directive which would grant their designated agent authorities of decision making when R1’s primary physician determines that R1 is unable to make their own healthcare decisions. Documents and interviews found that no such designation was recorded. Report continued Substantiated Interviews found that R1’s family members and the licensee thought that given R1’s cognitive and communication deficits, that R1 might be adversely affected by too many visitors or visits that were too long. There was no records of a doctor’s determination regarding the length or frequency of visits. The preponderance of attempted visitor statements also found that R1 was not asked, at the time of each attempted visit, if R1 wished to receive the visitor. In response to the frequency of visitors for R1, the licensee modified their visitation policies, instituting a visits by appointment only policy. As a result, visitors for R1 who did not make an appointment to visit R1 were, at times, turned away. The licensee did not submit the visitation policy change to their plan of operations to Community Care Licensing for review. As a result of this investigation, LPA finds allegation to be (S) Substantiated - A finding that the complaint is Substantiated means that the allegation is valid because the preponderance of the evidence standard has been met. The following deficiencies were cited on 9099-D, per Title 22 Regulations, Division 6. (A)This poses an immediate Health and Safety risk to clients/residents in care. (B) This poses a potential Health and Safety risk, or personal rights violation, to clients/residents in care. Report reviewed with Administrator . Copy of this report and appeal rights provided.the state’s words, verbatim · CDSS document, Nov 1, 2023 · control 59-AS-20230814113258

From the deficiency page — Deficiency type: Type B · Section cited: CCR 87468.1(a)(11) · Plan of correction due date: Nov 29, 2023

Personal Rights of Residents in All Facilities (11) To have their visitors, … permitted to visit privately during reasonable hours and without prior notice, provided that the rights of other residents are not infringed upon. This requirement was not met based on Records and interviews which found restrictions to R1's visitation. This posed a potential risk to R1,the state’s words, verbatim · CDSS document, Nov 1, 2023

Plan of correction: Licensee will submit a plan for review of residents's decision making for visitors and a policy for staff to verify with residents at all times, unless there are legally designated visit restrictions, when a visitor arrives during visiting hours. Licensee will also sumit proof of this training by the POC date of 11/29/23.