Vanessa Care Home II

Type of visit: Required - 1 Year

LPA Jeung toured facility and grounds, which includes a fenced backyard and 2-car garage. There are 6 client bedrooms and 2 staff rooms--one has one bed and the other has 2 beds--common bathroom, large living/dining area, and kitchen with eat-in dining table. All bedrooms have private full bathrooms and direct exits to outside. There are no accessible bodies of water or fire safety hazards observed. Sharps are stored appropriately and inaccessible to clients, and a comfortable temperature is maintained. Hot water temperature is tested within range of 105 and 120 degrees. Carbon monoxide detector is tested and operable. Food supply and first-aid kit are inspected. Client files are reviewed. A Disaster and Mass Casualty Plan is posted. Criminal record clearances or exemptions for facility staff or other individuals who have client contact have been reviewed, as well as staff records. There are 3 administrators associated to this facility: Licensee Ida Galati (x 7/26), Crystal Wright (x 10/26), Tina Galati (x 2/26). The following information/forms are requested to be sent to CCLD BY 10/2125: - LIC 308 Designation of Facility Responsibility - LIC 500 Personnel Report - Proof of current liability insurance Deficiencies of the RCFE California Code of Regulations, Title 22, Division 6, Chapter 8 are observed. See also Technical Advisory Notes--2 pages.the state’s words, verbatim · CDSS document, Oct 7, 2025

From the deficiency page — Deficiency type: Type A · Section cited: CCR 87468.1(a)(6) · Plan of correction due date: Oct 8, 2025

PERSONAL RIGHTS Residents have the personal right..to leave or depart the facility at any time and to not be locked into any room, building, or on facility premises by day or night. This requirement is not met, as glass sliding glass door in room #1 is secured with a screw & wood stick so client cannot access the door to exit. Side yard gate on south side is padlocked. Licensee failed to ensure that exits are accessible to clients, which poses an immediate health, safety or personal rights risk to clients in care.the state’s words, verbatim · CDSS document, Oct 7, 2025

Plan of correction: Wood stick and screw were removed from sliding door in room #1 and padlock was removed from side gate. Licensee to submit plan of correction describing how client will be monitored by staff without securing exit door shut.

From the deficiency page — Deficiency type: Type B · Section cited: CCR 87411(f) · Plan of correction due date: Oct 21, 2025

PERSONNEL REQUIREMENTS--GENL All personnel...shall be in good health, & physically & mentally capable of performing assigned tasks. Good physical health shall be verified by a health screening, including a chest x-ray or an intradermal test, performed by a physician not more than 6 months prior to or 7 days after employment or licensure. A report shall be made of each screening, signed by the examining physician. This requirement is not met, as there is no TB test result for Staff #3 & #4 & no health screening for staff #4.the state’s words, verbatim · CDSS document, Oct 7, 2025

Plan of correction: TB test results for staff #3 and #4 and health screening for Staff #4 to be sent to CCLD BY DUE DATE

From the deficiency page — Deficiency type: Type B · Section cited: HSC1569.696 · Plan of correction due date: Oct 21, 2025

HEALTH & SAFETY CODE All RCFEs shall provide training to direct care staff on postural supports, restricted conditions or health services, & hospice care...training shall include all of the following: 4 hours of training on the care, supervision, and special needs of those residents, prior to providing direct care to residents... This requirement is not met, as there is no evidence that staff received training on restricted health conditions, which poses a potential health, safety or personal rights risk to clients i care.the state’s words, verbatim · CDSS document, Oct 7, 2025

Plan of correction: Staff shall received required annual training on restricted health conditions, and proof whall be sent to CCLD BY DUE DATE.

From the deficiency page — Deficiency type: Type B · Section cited: CCR 87463(h) · Plan of correction due date: Oct 21, 2025

REAPPRAISALS The licensee shall request that all residents receive an annual routine visit with a licensed medical professional once every 12 months, either in person or by video appointment. Documentation of the annual routine visit, such as a visit summary, shall be added to the resident's record. record. This requirement is ot met, as MD reports for clients #2 and #4 are dated more than 12 months ago. Licensee failed to ensre that annual routine medical evaluations are documented, which poses a potential health, safety or personal rights risk to clients in care.the state’s words, verbatim · CDSS document, Oct 7, 2025

Plan of correction: MD reports for C2 and C4 will be signed and copies to be sent to CCLD BY DUE DATE

From the deficiency page — Deficiency type: Type B · Section cited: CCR87468(a) · Plan of correction due date: Oct 21, 2025

REAPPRAISALS The pre-admission appraisal...shall be updated in writing as frequently as necessary or once every 12 months, whichever occurs first.... and to keep the appraisal accurate. For the purposes of this section, the updated pre-admission appraisal shall be referred to as the reappraisal. This requirement is not met, as appraisals for clients #2, #3, #4 are dated more than 12 months ago. Licensee failed to ensure that appraisals are updated annually.the state’s words, verbatim · CDSS document, Oct 7, 2025

Plan of correction: Updated, signed appraisals for 3 clients to be sent to CCLD BY DUE DATE

Type of visit: Case Management - Deficiencies

LPA Jeung met with staff to discuss and review deficiencies cited on 9/20/24 during annual inspection--for which proof of corrections was not received--and to issue citation for first-aid certificates of 4 staff that were verified to be falsified by National CPR Foundation. On 10/4/24, licensee submitted first-aid certificates from National CPR Foundation for the same 4 staff, showing that the date completed was 9/30/24. Deficiencies are cited on a following page as per California Code of Regulations, Title 22, which includes deficiencies observed on 9/20/24. Ms. Galati is advised that annual fee of $742 is due and payable. Licensee is advised to obtain proof of payment from bank. The following licensing forms are requested to be submitted to CCLD BY 2/4/25: - LIC 308 Designation of Facility Responsibility - LIC 500 Personnel Report - LIC 999 Facility Sketch (including dimensions) Acknowledgement of corrections made as per 9/20/24 citations issued is given to Ms. Galati--4 pages,the state’s words, verbatim · CDSS document, Jan 21, 2025

From the deficiency page — Deficiency type: Type A · Section cited: CCR 87207 · Plan of correction due date: Jan 22, 2025

FALSE CLAIMS No licensee, officer or employee of a licensee shall make or disseminate any false or misleading statement regarding the facility or any of the services provided by the facility. This requirement was not met, as certificates of first-aid training for 4 staff were falsified. Licensee disseminated false information regarding first-aid training for staff, which poses an immediate health, safety, or personal rights risk to clients in care. National CPR Foundation certificates of completion for staff #2, #3, #4, #6 observed 9/20/24 are dated 5/11/25.the state’s words, verbatim · CDSS document, Jan 21, 2025

Plan of correction: Plan of correction will be submitted to CCLD BY DUE DATE, describing how false or misleading statements will NEVER be made or disseminated by any staff, including licensee.

From the deficiency page — Deficiency type: Type B · Section cited: CCR 87411(f) · Plan of correction due date: Feb 4, 2025

PERSONNEL REQUIREMENTS All personnel... shall be in good health, and physically and mentally capable of performing assigned tasks. Good physical health shall be verified by a health screening, including a chest x-ray or an intradermal test, performed by a physician not more than 6 months prior to or 7 days after employment or licensure. This requirement was not met, as there is no health screening and TB test result for staff #2. Licensee failed to ensure that all staff have health screeningTB test result, which poses a potential health, safety or personal rights risk to clients in care.the state’s words, verbatim · CDSS document, Jan 21, 2025

Plan of correction: Health screening and TB test result for staff #2 to be sent to CCLD BY DUE DATE

From the deficiency page — Deficiency type: Type B · Section cited: HSC1569.625(b)(2) · Plan of correction due date: Feb 4, 2025

HEALTH AND SAFETY CODE ... training requirements shall...include an additional 20 hours annually, 8 hours of which shall be dementia care training...& 4 hours of which shall be specific to postural supports, restricted health conditions, & hospice care, as required by subdivision (a) of Section 1569.696. This requirement was not met, as it cannot be determined if staff have received at least 8 hours of dementia training and 4 hours of annual hospice, restricted health conditions, and postural supoorts training, which poses a potential health, safety or personal rights risk to clients in care.the state’s words, verbatim · CDSS document, Jan 21, 2025

Plan of correction: Proof of annual 8 hours of dementia training, 4 hours of annual hospice, restricted health conditions and postural supports training for all staff will be sent to CCLD BY DUE DATE

Allegation investigated: - Licensee does not ensure that facility is maintained at a comfortable temperature for residents in care

On 11/26/2024 Licensing Program Analyst (LPA) Jaime Vado conducted an unannounced complaint investigation visit regarding the allegation received. LPA met with caregiver Mimi Arcenio initially then the administrator Tina Gilati arrived around 1250pm. LPA explained the purpose of today's visit. During the investigation LPA conducted interviews and made facility observations. LPA also made facility observations and took temperature readings in resident rooms and in common areas which ranged from 65F down to 63F towards rooms 4 and 5. Temperature is observed to be 65F based on thermostat reading in the facility. Additonally LPA observed that the thermostat is set at maintaining 65F per observation of the thermostat/centralized heating control in the kitchen area. LPA observed three residents in the dining area. All three are wearing warm clothing such as outdoor vest, with a long sleeve flannel and another with a long sleeve sweater beneath a vest. Another resident is wearing a sherpa jacket with a scarf or head wrap to keep her head and ears warm. The temperature readings and thermostat setting do not meet the minimum 68F as outlined in regulations. Based on the information gathered, and observations made, this allegation is substantiated. Based on LPA interviews and items letters received, the preponderance of evidence standard has been met, therefore the above allegation is found to be SUBSTANTIATED. California Code of Regulations, Title 22, Division 6, are being cited on the attached LIC9099D. Report is reviewed with the administrator Tina Gilati and a copy is provided. Substantiatedthe state’s words, verbatim · CDSS document, Nov 26, 2024 · control 14-AS-20241118163445

From the deficiency page — Deficiency type: Type B · Section cited: CCR 87303(b)(1) · Plan of correction due date: Dec 2, 2024

Maintenance and Operation - (b) A comfortable temperature for residents shall be maintained at all times. (1) The facility shall heat rooms that residents occupy to a minimum of 68 degree F, (20 degrees C). This regulation has not been met as evidenced by: Based on observations made, interviews conducted, and temperature readings taken and observed, the temperature is mainly 65F in some areas. The temperature does go down further to around 63F near rooms 4 and 5. These readings and observations made do not meet the minimum temperature of 68F as outlined in regulations. This poses a potential health and safety risk to residents in care.the state’s words, verbatim · CDSS document, Nov 26, 2024

Plan of correction: The facility shall provide a written plan identifying how they will ensure that the facility maintains a minimum temperature of 68F at all times and mearues being taken. This plan is to be received by the due date of 12/02/2024.

Type of visit: Required - 1 Year

LPA Jeung toured facility and grounds, which includes a fenced backyard and 2-car garage. There are 6 client bedrooms and 2 staff rooms--with 2 beds--common bathroom, large living/dining area, and kitchen with eat-in dining table. All bedrooms have private full bathrooms. There are no accessible bodies of water or fire safety hazards observed. Sharps are stored appropriately and inaccessible to clients, and a comfortable temperature is maintained. Hot water temperature is tested within range of 105 and 120 degrees. Carbon monoxide detectors are tested and operable. Food supply and first-aid kit are inspected. Client files are reviewed, and medications are recorded on Centrally Stored Medications Records. A Disaster and Mass Casualty Plan is posted. Criminal record clearances or exemptions for facility staff or other individuals who have client contact have been reviewed, as well as staff records. There are 4 administrators associated to this facility: Licensee Ida Galati, Crystal Wright (x 10/24), Melba Mendoza (x4/25), Tina Galati (x 2/26). The following information/forms are requested to be sent to CCLD BY 10/4/24: - LIC 308 Designation of Facility Responsibility - LIC 500 Personnel Report - LIC 999 Facility Sketch (including dimensions) - LIC 9282 Infection Control Plan (including page 5, signed and dated) - Proof of current liability insurance Deficiencies of the RCFE California Code of Regulations, Title 22, Division 6, Chapter 8 are observed. See also Technical Advisory Notes--6 pages.the state’s words, verbatim · CDSS document, Sep 20, 2024

Type of visit: Required - 1 Year

On November 3, 2023, Licensing Program Analyst (LPA) Komal Charitra conducted an unannounced annual inspection. LPA met with Administrator, Ida Galati and explained the purpose of the visit. LPA toured the facility inside and outside including all of resident rooms, common areas & kitchen. The indoor and outdoor passageways were observed. Outdoor passageways was observed to have furniture. No accessible bodies of water of fire safety hazards observed. Two staff rooms were observed. Resident rooms were observed to be equipped with required furnishings and bathrooms were observed to be clean and odor-free. Water temperature throughout the facility measured at 85.1-95.7 degrees F. A comfortable temperature of 69 degrees F is maintained and lighting is sufficient for comfort. Door alarms were observed to be off and not working. Sharps and toxins were observed to be unlocked and accessible to residents. Medication cabinet was observed to be locked. Carbon monoxide monitors are working properly. All fire extinguishers have been checked and current as of November 2022. LPA observed 2 days for perishables and 7 days non-perishables. LPA observed expired milk in the refrigerator and opened bottles of mayonnaise and mustard in the kitchen pantry. Emergency drills were not observed. According to Administrator, drills are conducted every month, however she was unable to locate the training logs. LPA reviewed 4 resident records and 3 staff records. Based on record reviews: 3/4 residents did not have an updated physician's report and 4/4 files did not have a needs and service plan. Based on 3/3 staff records reviewed, staff records were observed to be complete, however training logs were not provided by the administrator. Medication review was done, and all medications are accounted for, and centrally stored medication records are updated. Deficiencies of the California Code of Regulations, Title, 22 cited on the LIC809-D. Failure to correct the deficiencies may result in additional civil penalties. Report is reviewed with Administrator and a copy is provided.the state’s words, verbatim · CDSS document, Nov 3, 2023