A New Haven Care Home - Berlin

On this day, May 25, 2023, Licensing Program Analyst (LPA) Delmundo arrived unannounced to conduct a health and safety inspection as a result of the Department receiving a priority 2 complaint (Complaint # 15-AS-20230523113154). LPA was granted entry by staff, Leah Van Alstin, Robert Abella. administrator, arrived after several minutes, followed by Arnold Soleta, licensee. LPA informed the reason for visit. Licensee has to leave and excused himself. LPA toured the facility inside out with the administrator. LPA inspected including but not limited to living room, dining area, kitchen, ensuite and common bathrooms, kitchen, family room. side and backyard. Hot water temperature in the common bathroom was tested, and measured at 119.5 degrees Fahrenheit. LPA observed the following: -At 12:19 p.m. Lysol spray and razor in one of the common bathrooms. -At 12:21 p.m., 2 bottles Glade spray, resident's (R1) Vicks VapoRub, Desitin cream, Afrin nasal spray, topical cream, Gold Bond pain and itch relief cream, anti-fungal cream in the other common bathroom -At 12:27 p.m., Calmoseptin cream, Desitin maximum strength diaper rash paste in 2 resident's bedrooms. -At 1:15 p.m,, LIC625 for 2 residents were incomplete and/or inaccurate. One has no signature while the other one is dated 12-01-23. -At 1:30 p.m., staff (S1) record is not at the facility for review. Administrator and LPA asked, S1 stated her file is in her house. ......continued on 809C 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 Deficiencies are cited from Title 22 California Code of Regulations and listed on 809Ds. A $250.00 civil penalty is assessed for repeat violation within 12 month of Regulation section 87309(a) . This Regulation was cited on February 10, 2023. Failure to submit proof of corrections by plan of correction due dates may result in additional civil penalties. Deficiencies and plan and proof of corrections were discussed with Arnold Soleta over the phone in the presence of Robert Abella. Exit interview conducted. Appeal Rights, LIC421FC Civil Penalty Assessment. LIC9098 Proof of Correction form and copy of this report provided.

On 3/11/2022 at 3:20PM, Licensing Program Analyst (LPA) G. Luk arrived unannounced to conduct an Infection Control Inspection. LPA met with Administrator, Roberto Abella. Upon entry, LPA's temperature was checked and asked to fill out visitor's log. LPA observed hand sanitizer at screening station. LPA toured facility including but not limited to bedrooms, bathrooms, kitchen, common areas, and outdoor areas. LPA observed cough etiquette, signs & symptoms, and physical distancing are posted in the common areas. All hand washing stations were equipped with soap and paper towel. Hand washing posters were posted at sinks and bathrooms. During record review, LPA observed visitors log and temperature log for both residents and staff. LPA observed facility has a copy of Mitigation Plan on file. Staff were FIT tested and have certificate card on file. LPA observed food supplies and paper supplies are sufficient. No deficiencies are being cited on this date. Exit interview conducted. A copy of this report provided.

On 3/18/2026 at 2:20PM, Licensing Program Analyst (LPA) G. Luk arrived unannounced to conduct a Required - 1 Year inspection. LPA met with Administrator, Robert Abella and caregiver, Imee Baquir. LPA explained the purpose of the visit. LPA toured the facility including but not limited to bedrooms, bathrooms, dining area, kitchen, garage, and outdoor area. Smoke and carbon monoxide detectors were observed. Fire extinguisher was observed to be full and last serviced on 2/4/2026. First Aid kit is complete. One week of nonperishable and 2-day of perishable food supplies were available. Hot water temperature was measured at 105.1 degrees F in the hallway bathroom. LPA observed grab bars and non-skid mat in the bathrooms. There were adequate lights in each room. Resident rooms were observed to be cleaned and fully furnished. Indoor and outdoor passageways were free of obstruction. There was no bodies of water observed. LPA reviewed 5 residents and 3 staff files starting at 2:24PM. Residents and staff files were complete. Staff are fingerprint cleared and associated to the facility. LPA reviewed a sample of resident's medications during inspection. No deficiencies are being cited on this date. Exit interview conducted with Robert Abella. A copy of this report and technical violation was provided.

While conducting an investigation of a complaint (Control # 15-AS-20230523113154), the Department observed that staff’s (S1) fingerprint clearance was still in process (pending) as of 05/24/2023. Copy of S1’s LIC501 Personnel Record obtained from Arnold Soleta, licensee, showed 05/16/2023 as S1’s date of employment. S1 was fingerprint cleared and associated to other facility as of 03/07/2023 but not associated to A New Haven Care Home - Berlin. S1 was associated only on 05/25/2023. On this day, September 27, 2024, Licensing Program Analyst (LPA) Delmundo conducted a case management as a result of the above. LPA met with Administrator (ADM) Roberto 'Robert' Abella. LPA called and spoke with Arnold Soleta, licensee, over the phone, and informed the reason for visit. Deficiency is cited from Title 22 California Code of Regulations and listed on 809D. Failure to submit proof of correction by plan of correction due date and any repeat violation within 12-month period may result in civil penalty. Deficiency and plan and proof of correction were discussed with licensee over the phone in the presence of ADM. Exit interview conducted. Appeal Rights, LIC9098 Proof of Correction form and copy of this report provided.

On 3/21/2024 at 12:15PM, Licensing Program Analyst (LPA) G. Luk arrived unannounced to conduct a Required - 1 Year inspection. LPA met with Administrator, Robert Abella and explained the purpose of the visit. The facility’s fire clearance was approved for 6 non-ambulatory residents of which 3 residents maybe under hospice care. LPA toured the facility including but not limited to bedrooms, bathrooms, dining area, kitchen, garage, and outdoor area. Smoke and carbon monoxide detectors were observed. Fire extinguisher was observed to be full and last serviced on 2/2/2024. One week of nonperishable and 2-day of perishable food supplies were available. Hot water temperature was measured at 110.6 degrees F in the hallway bathroom. LPA observed grab bars and non-skid mat in the bathrooms. There were adequate lights in each room. Resident rooms were observed to be cleaned and fully furnished. First Aid kit is complete. LPA reviewed 4 residents and 3 staff files starting at 1:15PM. LPA reviewed a sample of resident's medications starting at 2:30PM. LPA interviewed 2 residents and 2 staff at around 2:00PM. No deficiencies are being cited on this date. Exit interview conducted. A copy of this report provided.