Sunshine Glory Care Home

Type of visit: Case Management - Health Checks

Licensing Program Analyst (LPA) Christina Valerio arrived unannounced to conduct a health and safety case management visit. The facility is on quarterly visits due to non-compliance concerns discussed during an office meeting on 02/18/2020. LPA met with Administrator Merly Aguda, and explained the purpose of the visit. LPA toured the physical plant to ensure compliance with Title 22 regulations. Today, there were 2 staff on shift that were observed to be fingerprint cleared. LPA observed resident bedrooms, bathrooms, common areas, exterior plant, chicken coop, shed, and smoking area. LPA observed resident bedrooms and bathrooms to have necessary furniture and furnishings. Bedrooms were equipped with a bed, chair, dresser, and closet space. Bathrooms were stocked with paper towels, soap, and hand rails. Temperature inside the home is 69*F. LPA observed the front yard to have a new patio, water fountain, and sitting area. Fire extinguishers were up to date and fully charge. No emergency exits were obstructed. LPA requested to review 2 resident files and 2 staff files. Administrator Merly stated she has yet to receive her certificate; however, she provided proof she sent renewal items to the Department. Staff files and resident files were observed to be current with up to date files. During the visit, residents were observed eating breakfast, doing chores, doing ADLs, going into the backyard, and going to their outside visits. LPA spoke to multiple residents during the visit. Per California Code of Regulations, Title 22, Division 6, Chapter 8, no deficiencies observed. An exit interview was held, and a copy of the report was provided.the state’s words, verbatim · CDSS document, Aug 7, 2023

Type of visit: Case Management - Health Checks

Licensing Program Analyst (LPA) Christina Valerio arrived unannounced to conduct a health and safety case management visit. The facility is on quarterly visits due to non-compliance concerns discussed during an office meeting on 02/18/2020. LPA met with Administrator Merly Aguda, and explained the purpose of the visit. LPA toured the physical plant to ensure compliance with Title 22 regulations. Today, there were 3 staff on shift. LPA observed 3 resident bedrooms, 3 bathrooms, common areas, and exterior plant. LPA observed resident bedrooms and bathrooms to have necessary furniture and furnishings. Bedrooms were equipped with a bed, chair, dresser, and closet space. Bathrooms were stocked with paper towels, soap, and hand rails. LPA observed the common area floors and bathroom floors to be stained with dirt or old stains. Administrator stated that the floors are cleaned but the stains would not come out. This poses a potential health and safety risk to residents in care. Sheds in the backyard area were observed to be used for storage. LPA requested to review 2 resident files and 3 staff files. LPA observed Administrator Certificate for Merly Aguda to be up to date with an expiration date of 06/29/23. Administrator Merly stated she is working on her renewal application. The 3 staff files were observed to be within compliance of Title 22 regulations. 1 out of 2 resident files were not within compliance due to an appraisal services and needs form not being updated. During the visit, residents were observed to be smoking in the designated area, watching television in the common area, completing ADLs, and receiving assistance from staff. Staff were observed cleaning, cooking lunch, assisting residents with calls, prompting residents with daily reminders, and observed speaking positively and encouraging. Per California Code of Regulations, Title 22, Division 6, Chapter 8, deficiencies were observed during this visit. Appeal Rights were provided. An exit interview was held, and a copy of the report was provided.the state’s words, verbatim · CDSS document, Apr 10, 2023

From the deficiency page — Deficiency type: Type B · Section cited: CCR 87303(a)(1) · Plan of correction due date: May 10, 2023

87303 Maintenance and Operation a) The facility shall be clean, safe, sanitary and in good repair at all times....(1) Floor surfaces in bath, laundry and kitchen areas shall be maintained in a clean, sanitary, and odorless condition. This requirement was not met as evidenced by: Based on observations, the floors in the hallway near resident bedrooms and in the main rooms were not maintained clean, sanitary, or in good repair. This poses a potential health and safety risk to residents in care.the state’s words, verbatim · CDSS document, Apr 10, 2023

Plan of correction: Licensee stated that they will do a power wash of the of floors, clean the surrounding areas with bleach, obtain a quote of the flooring. Licensee to submit proof of services and cleans floors by POC due date.

From the deficiency page — Deficiency type: Type B · Section cited: CCR87463(c) · Plan of correction due date: May 10, 2023

87463 Reappraisals (c) The licensee shall arrange a meeting with the resident, the resident’s representative, or once every 12 months, as specified in Section 87467, Resident Participation in Decision Making. This requirement was not met as evidenced by: Based on records review, the licensee did not ensure 1 out of 2 resident files reviewed had an updated appraisal services and needs form completed. This poses a potential health and safety risk to residents in care.the state’s words, verbatim · CDSS document, Apr 10, 2023

Plan of correction: Licensee stated she will update the forms, send a faxed copy, and will review the regulation 87463. LPA to receive a written notification of understanding for 87463 by POC due date.

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Christina Valerio arrived to the facility unannounced to conduct an annual inspection. LPA was met by Administrator Merly Aguda, and explained the purpose of the visit. Administrator was in the process of cleaning, preparing documents, and having repairs done at the time of visit. Due to the recent storms, their roof had two leaks. LPA observed a maintenance person repairing 1 out of 2 leaks during the visit. Administrator stated he will be fixing both today. LPA and Administrator toured the facility inside and out to ensure compliance with Title 22 regulations. LPA observed 3 staff and 10 residents. Residents were observed eating breakfast, watching television, cleaning up the rooms, and using the computer. Staff were observed cleaning the kitchen, bathroom, and common areas. Resident rooms were observed to have necessary furniture and furnishings. Common areas were cluttered; however, staff were in the middle of cleaning. Resident bathrooms were supplied with soap, towels, and a trash can. Hand sanitizers were also observed. Hot water was measured at 108.7*F. Room temperature was measured at 70*F. A pull alarm fire system and fire extinguishers were observed throughout the home to be within compliance. Last check on 04/22/2022. Their is a new patio in the front of the home, which they are hoping to use in the summer. It is equipped with a BBQ grill, a large seating area, and a nice paved walkway. The backyard was free from sharp objects and clear from debris. Shed areas were observed to have old appliances, yard tools, and items not in use. The facility was observed to have emergency supplies, such as a generator, water, canned goods, flash lights, batteries, and blankets. LPA requested the following documentation: LIC 500, LIC 308, LIC 610D, and Liability Insurance Per California Code of Regulations (CCR), Title 22, no deficiencies are being cited today. An exit interview was held, and a report was provided.the state’s words, verbatim · CDSS document, Jan 23, 2023

Type of visit: Case Management - Health Checks

Licensing Program Analyst (LPA) Christina Valerio arrived unannounced to conduct a health and safety case management visit. LPA Valerio was met by Administrator Merly and explained the purpose of the visit. Administrator confirmed that there are 0 residents or staff that have displayed any signs or symptoms of COVID-19 in the last 10 days. During the visit, LPA Valerio observed residents eating lunch. LPA engaged with residents during the visit. Residents were observed to be happy and enjoying their meal. LPA observed the facility to have sharps locked away in the cabinet while staff cleaned the kitchen. Staff working were observed to be cleared and finger printed. Staff training files were up to date. LPA requested copies of in-service be sent via fax. LPA requested the infection control plan be sent to LPA Valerio by COB 08/15/22. LPA observed the front yard to be under construction. Administrator stated they are planting new trees and going to install a new grill. Per California Code of Regulations, Title 22, Division 6, Chapter 8, no deficiencies were observed during this visit. An exit interview was held, and a copy of the report was given to Administrator Merly Aguda.the state’s words, verbatim · CDSS document, Aug 8, 2022

Allegation investigated: Unlawful Eviction

Licensing Program Analyst (LPA) Christina Valerio and LPA Jamie Ivey Canady arrived at the facility unannouced to deliever complaint investigation findings. LPAs met with Administrator Merly Aguda and explained the purpose of the visit. The Department has determined the following as it relates to the complaint allegation: Unlawful Eviction On 12/10/2021, the department recieved notication regarding a eviction notice for Resident 1 (R1). The department approved the eviction notice based on R1 needing a higher level of care that the facility could provide. Administrator Merly stated R1's responsible party was notified verbally regarding the eviction prior to the department approving the eviction. Administrator Merly stated she extended the discharge date to Febraury 2022 to allow time to find placement. On Feburary 2, 2022, R1 discharged to live with family. Continues on LIC 9099 - C.. Page 1 of 2 Unsubstantiated Continued from LIC 9099 According to interviews with responsible parties (RP 1 and RP2), there was verbal discussion regarding Resident 1's behaviors, medical appointments, and eviction notice since late October and early November of 2021. However, RP1 stated an eviction noticed was not received until late December/early January. RP1 stated it was a surprise when Administrator Merly informed RP1 of the discharge date of 02/02/2022 because there was no clear conversation about the eviction. RP2 stated a copy of the notice was sent by RP1 to RP2 in early January 2022. RP2 stated RP1 was aware of the eviction and understood there was a time frame. According to an interview with R1, R1 does not recall receiving an eviction notice or had conversations with staff about leaving the facility in February. According to records review, the eviction notice was not signed by responsible parties or resident. Discharge documents were signed by RP1 and R1 on 02/02/2022. Discharge Documents were signed on 02/05/2022 by RP1 for R1's belongings. According to records review and interviews, the administrator did not inform the payee of the discharge date and address change. A check was sent to Administrator Merly for February 2022 rent. Administrator Merly stated she sent the check back to the payee because of the discharge of R1. Based on all the information collected by the Department there is not a preponderance of evidence to prove the allegation occurred, therefore this allegation is UNSUBSTANTIATED. Per California Code of Regulations (CCRs) - Title 22, Division 6, Chapter 8, no deficiencies cited. TA was provided due to eviction notices not being signed by RP1 and R1 and the payee not being notified of eviction. Exit interview was held and a copy of report was given to Administrator Merlythe state’s words, verbatim · CDSS document, Mar 21, 2022 · control 27-AS-20220203133438

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Christina Valerio arrived at the facility unannounced to conduct the annual inspection. LPA Valerio confirm with Administrator that zero residents or staff have displayed signs or symptoms of COVID in the last 10 days. LPA was screened by Administrator prior to being allowed entry into the facility. LPA Valerio completed the infection domain tool, discussed PIN 21-53 and PIN 22-04, and reviewed facility COVID tracking procedures. Facility staff are said to clean multiple times per shift. COVID-19 signs regarding social distancing, hand washing, infection control, and prevention strategies are placed at the front area of the home. Visitors are encouraged to meet outdoors on the front patio. LPA Valerio and staff toured the physical plant interior and exterior to ensure compliance with Title 22 regulations. All emergency exits were clear from obstructions. A two-day supply of perishable foods and a seven-day supply of non-perishable foods were observed in the refrigerators and freezers. An emergency supply of food and water was observed. Medication cabinet, cleaning supplies, and sharps were locked away and inaccessible to residents in care. Hot water was measured at 117.1*F. Room temperature was set to 74*F. All required furniture and furnishings were observed in the resident bedrooms and bathrooms. Fire extinguishers were observed to be charged and within compliance with last check on 04/08/2021. LPA Valerio was made aware of future carpet changes in the hallway, which is said to be completed by April 2022. LPA reviewed facility documentation binder and discussed emergency disaster plan with Administrator Merly. LPA requested facility documentation to be sent via fax by COB 02/10/2022: Administrator Certificate, LIC 610, LIC 308, LIC 500, LIC 309, Liability Insurance. Per California Code of Regulations, Title 22, Division 6, Chapter 8, no deficiencies were observed during this visit. An exit interview was held, and a copy of the report was left at the facility with the Administrator Merly Aguda.the state’s words, verbatim · CDSS document, Feb 3, 2022

Type of visit: Case Management - Health Checks

Licensing Program Analyst (LPA) Christina Valerio arrived at the facility unannounced to conduct a case management visit due to the regional office receiving notification that the facility has bed bugs and that a resident received an eviction notice. LPA Valerio attempted to contact the facility, however, the line was busy. LPA Valerio was met at the front door by Administrator Merly. Administrator confirmed zero residents and staff have displayed any signs or symptoms of COVID-19 in the last 10 days. LPA Valerio was screened for COVID-19 symptoms prior to being allowed entry. Administrator Merly stated there are currently 10 residents. Zero residents have been given an eviction notice. Administrator stated there is not bed bugs at the facility. The facility is serviced for pest from Ambush Pest Control. A telephone interview was conducted with Ambush Pest Control Representative and Administrator Merly. Ambush Pest Control Representative stated that there has not bed bugs in the facility for a few years. The representative comes once a month to service the inside of the home and outside of the home. LPA obtained most recent copy of service. LPA to receive a letter from Ambush to confirm that there is no current bed bugs in the facility. LPA inspected the facility. There was an odor in the front of the home. LPA Valerio advised that the licensee obtain air freshener for the home. LPA observed that the knives were kept in am unlocked cabinet instead of the locked cabinet, which poses a potential health and safety risk to residents and staff. Per California Code of Regulations, Title 22, Division 6, Chapter 8, deficiencies were observed during this visit and can be found on LIC 809-D. An exit interview was held, and a copy of the report was given to Administrator Merly Aguda.the state’s words, verbatim · CDSS document, Nov 30, 2021

From the deficiency page — Deficiency type: Type B · Section cited: CCR 87309(a)(1) · Plan of correction due date: Dec 7, 2021

87309Storage Space (a) Disinfectants, cleaning solutions, poisons, firearms and other items which could pose a danger if readily available to clients shall be stored where inaccessible to clients.(1) ...other dangerous weapons shall be locked. This requiement was not met as evidenced by: Based on observation, the licensee did not ensure that sharps were locked and inaccessible to clients, which poses a potential health and safety risk to persons in care.the state’s words, verbatim · CDSS document, Nov 30, 2021

Plan of correction: The licensee will buy a lock box or lock for the cabinet to ensure that the sharps are kept locked and inaccessible to clients moving forward. Licensee to send picture to LPA Valerio showing locked sharps by POC.

Type of visit: Case Management - Health Checks

Licensing Program Analyst (LPA) Christina Valerio arrived unannounced to conduct a Health and Safety Case Management Visit. LPA Valerio was met with Administrator Merly Aguda and explained the purpose of the visit. Administrator confirmed no residents or staff have displayed any signs or symptoms of COVID-19 in the last 10 day. LPA Valerio inspected resident bedrooms, resident bathroom, common areas, kitchen, and backyard. Resident bedrooms were furnished with a bed, night stand, trash can, chair, and dresser. Residents who share a room have beds spaced 6 feet apart. Resident bathrooms had liquid soap, hand sanitizer, a trash can, and paper towels. LPA Valerio inspected the kitchen area and food storage areas. The refrigerators and freezers had food items that were labeled and dated. LPA observed the facility to have adequate food supply, enough perishable foods for 2 days and non-perishable foods with 7 days, with an emergency food supply located in a separate freezer and pantry. LPA Valerio interacted with multiple residents during the visit. Residents were observed watching television in the day room, sitting in the backyard, sweeping the leaves outside, on the computer, and sitting in their rooms. LPA Valerio reviewed 2 residents files and 2 staff files. LPA Valerio did not observe any health and safety issues during the visit. Per California Code of Regulations, Title 22, no deficiencies were observed during this visit. Exit interview was held and a copy of the report was given to Administrator Merly Aguda.the state’s words, verbatim · CDSS document, Oct 21, 2021

Type of visit: Case Management - Health Checks

On 08/18/21 at 10:00 AM, Licensing Program Analyst (LPA) Christina Valerio arrived unannounced to conduct a Health and Safety Case Management Visit. LPA Valerio was met with Administrator Merly Aguda and explained the purpose of the visit. LPA Valerio inspected resident bedrooms, resident bathroom, common areas, kitchen, garage, and backyard area. Administrator informed LPA that she is working on improving the home. Resident bedrooms were furnished with a bed, nightstand, trash can, chair, and dresser. Resident bathrooms had liquid soap, hand sanitizer, a trash can, and paper towels. LPA Valerio inspected the kitchen area and food storage areas. The refrigerators and freezers had food items that were labeled and dated. LPA observed the facility to have adequate food supply, enough perishable foods for 2 days and non-perishable foods with 7 days, with an emergency food supply. LPA Valerio interacted with multiple residents during the visit. Residents were observed watering the garden, watching television in common areas and bedroom, in their room, and one resident sweeping buds in the smoking area. LPA Valerio did not observe any health and safety issues during the visit. Per California Code of Regulations, Title 22, no deficiencies were observed during this visit. Exit interview was held and a copy of the report was given to Administrator Merly Aguda.the state’s words, verbatim · CDSS document, Aug 18, 2021

Type of visit: Required - 1 Year

On 08/18/21 at 10:00 AM, Licensing Program Analyst (LPA) Christina Valerio arrived at this facility unannounced to conduct an annual inspection visit. LPA Valerio introduced herself, met with Administrator Merly Aguda, and explained the purpose of the visit. Additionally, LPA Valerio was screened for COVID-19 symptoms with temperature prior to being allowed inside the facility. LPA Valerio inspected the physical plant including but not limited to the kitchen, dining room, resident bedroom, resident bathroom, laundry room/storage room, living room, staff bedroom, and outside areas of the facility to ensure compliance with Title 22 regulations. LPA also conducted the infection control domain tool. The facility has an LIC 808 mitigation plan on file. The facility has one central entry point and has implemented screening and sign in procedures at the front of the home. The facility is able to host indoor and outdoor visits. LPA observed the facility to have COVID-19 informational signs at the front door. The facility is able to designated and dedicated a Covid-19 bedroom and bathroom if needed. Administrator has implemented cleaning of common areas after each use. LPA Valerio recommended facility to create a PPE bin and to print out additional CDC guidelines for Donning and Doffing. Water temperature reads 111.2° F, within regulatory range of 105*F and 120 *F. Room temperature reads 77° F. Smoke and carbon detectors were in good repair. Fire extinguishers was up to date with last check on 04/09/2021. Medications cabinet and cleaning supplies was locked. LPA Valerio smelled an odor in the front area of the home. LPA observed staff cleaning of the vent, floors, and common areas at the time of visit. LPA obtained updated facility documentation: LIC 500 personnel report, LIC 610E Emergency Disaster Plan, Liability Insurance, and Microbiological Water Analysis. Per California Code of Regulations, Title 22, no deficiencies were observed during this visit. Exit interview was held and a copy of the report was given to Administrator Merly Aguda.the state’s words, verbatim · CDSS document, Aug 18, 2021