Monteverde Manor

As part of the investigation, LPA interviewed R1, the administrator, staff member and review documentation, LPA interviewed R1 who stated that facility staff was providing good care and R1 was comfortable at the facility. The administrator denied the allegation and stated that R1 was admitted with a pressure ulcer and home health nurse was providing treatment to the wound. However, R1 was not compliant with being turned and repositioned resulting wound got worse. The administrator stated that this observation was noted and documented by the home health nurse and facility staff. LPA interviewed staff #1(S1) who stated that they turned and repositioned R1 every 2 hours but sometimes R1 did not want to comply, but they continued to encourage. S1 stated that R1’s wound was being treated by the home health and hospice nurses. Based on documentation provided by the facility, it revealed that R1 was refusing to be turned by the facility staff and refused pressure injury prevention measures that were recommended by the home health nurse. After the investigation, this allegation is deemed to be unfounded as R1 stated that he/she was comfortable and facility staff was providing good care. In addition, facility documentation indicated that R1 was refusing pressure ulcer prevention measures and safety precautions. The Department has investigated the complaint allegations of possible physical plant violations. It was determined the allegations are unfounded, meaning the allegations are false, could not have happened and/or is without a reasonable basis and therefore dismissed.

On April 24, 2024 Licensing Program Analyst (LPA) Murial Han conducted an unannounced annual inspection. LPA met with caregiver, Irma Alcantara and explained the purpose of the visit. The administrator, Dino Martin arrived at the end of the inspection. LPA toured the facility inside out and inspected the living room, dining area, kitchen, bedrooms, bathrooms, garage, side yard and backyard. The facility has 5 resident rooms (one shared room) and 1 staff room. Food supplies were sufficient of 2- days perishables and 7- days of non-perishables. Lamp and lights were present in all rooms and hallways. Toilet, hand washing and bathing areas were observed clean and in operating condition. Showers were observed equipped with non-skid mats and grab bars. Central storage for medications was locked. During the tour of the garage, LPA observed it was sectioned off in the middle and one side consisted of washer, dryer and storage cabinets and on the other side, a staff was sleeping in a tent and other furniture around it. Hot water temperature in the kitchen and bathroom were measured at 106- 111 degrees Fahrenheit. Fire extinguisher checked and last inspected on October 26. 2023. Sharps, chemical and toxins were observed to be locked and inaccessible to residents in care. LPA reviewed 3 resident files and 3 staff files. The following documents were requested submitted to CCL by 4/25/24: - liability insurance; and copy of administrator certification. Based on observation, deficiency is cited under California Code of Regulations, Title, 22 cited on the LIC 809D. Failure to correct the deficiencies may result in civil penalties. . This report is reviewed and discussed with administrator. A copy of this report and the appeal rights were provided.

On May 24, 2022, Licensing Program Analyst (LPA) Komal Charitra conducted an unannounced plan of correction (POC) visit to follow up on POC visit made on May 12, 2022. LPA Charitra met with Caregiver, Renato Pera, and explained the purpose of the visit. Caregiver called, Administrator, Dino Martin and LPA also explained the purpose of the visit. On 4/26/2022, the facility was cited for California Code of Regulation (CCR), 87506(c)(1) Resident Records. The plan of correction for this citation was due to CCLD by 5/3/2022, however the facility administrator failed to provide CCLD a plan of correction by the due date. On 5/12/2022, LPA visited the facility to verify the POC, however, the facility administrator was unable to provide LPA Charitra with a POC. LPA issued a civil penalty from 5/4/2022 through 5/12/2022 and notified administrator that the civil penalty will continue to accrue until corrected. On 5/18/2022, LPA Charitra received the POC from the Administrator. Deficiency is now verified as corrected and cleared. Another civil penalty will be assessed in the amount of $100 a day from 5 /1 2/2022 though 5/18/2022. Civil penalties stopped on 5/18/2022. Total civil penalty assessed today = $600.00 Report is reviewed with Caregiver and a copy is provided with appeal rights.

On May 12, 2022, Licensing Program Analysts (LPA) Komal Charitra conducted an unannounced plan of correction (POC) visit to verify and to confirm that the facility is in compliance with the citation that were issued on 4/26/2022. LPA Charitra met with Caregiver, Renato Pera, and explained the purpose of the visit. Caregiver called, Administrator, Dino Martin and LPA also explained the purpose of the visit. On 4/26/2022, the facility was cited for California Code of Regulation (CCR), 87506(c)(1) Resident Records. The plan of correction for this citation was due to CCLD by 5/3/2022, however the facility administrator failed to provide CCLD a plan of correction by the due date. In addition, facility administrator did not ask LPA Charitra for an extension. During the visit, administrator was still not able to provide LPA with a POC for the cited deficiency. However, the administrator did indicate he is currently working clearing the deficiency. Due to the citation 87506(c)(1) Resident Records, not being corrected by 5/3/2022, a civil penalty is being assessed in the amount of $100 a day from 5/4/2022 through 5/12/2022 and will continue to accrue until corrected. Report is reviewed with Caregiver, Renato Pera, and a copy if provided with the appeal rights.