Villas at Saratoga Skilled Nursing & Asst Lvg, the

On 9/18/2024 Licensing Program Analysts (LPAs) Maria (Mita) Partoza and Marcela Yanez, conducted an unannounced Annual Continuation inspection and met with Director of Staff Development (DSD) Josephine Almonte and Facility Registered Nurse (FRN) Analie Limosnero. At 10:15 a.m. LPAs continued to review the facility record for staff and residents. LPAs reviewed 5 out of 5 resident files. LPAs observed 2 out of 5 resident file needs LIC 602 (Physician's Report) updates and appraisal needs and services plan (LIC 625). DSD and FRN stated they have scheduled a meeting with family and Primary Care Physician (PCP) to update the record. Once updated DSD and FRN stated they will submit completed forms, LIC 625 and LIC 602 to LPA. At 11:40 a.m. LPAs reviewed 5 out of 5 Staff records and observed 1 out 5 staff records needs updating for education, however, S2 has a valid CNA license. LPAs discussed with DSD and FRN the importance of maintaining and updating staff records. LPAs observed that staff records have current training and current valid certification to provide care and supervision to residents in care. LPAs requested the following documents for CCLDs record updated, LIC 500, copy surety bond, copy of admission agreement and LIC 308 were provided. LPAs provided technical assistance for the maintenance/upkeep of residents and staff records. No deficiencies were cited during todays visit based on California Code of Regulation (CCR) Title 22. An exit interview was conducted with DSD Josephine Almonte and FRN Analie Limosnero. A copy of the report was provided.

Licensing Program Analyst (LPA) Maria (Mita) Partoza conducted an unannounced required 1 year inspection visit and met with Director of Staff Development (DSD) Josephine Almonte.  LPA stated the purpose of the visit. The facility is licensed to serve adults age 60 years and over; approved for capacity of 74 non-ambulatory, residents, approved hospice waiver for 10 hospice residents. At 2:30 pm LPA observed that residents were in the activity area lobby and most of the residents were participating. LPA toured the facility accompanied by the DSD. including but not limited to the kitchen, bathroom, dining room, living room, 5 of 34 residents rooms, and exterior walkways. The temperature inside the facility is at 74 degrees Fahrenheit. The facility is a 3 floor level building and each level has a medication room that is locked and not accessible to residents, a kitchen/kitchenette and dining room. The kitchen was observed to be sanitary and organized, knives and sharps were locked and not accessible to residents. LPA observed 2 days of perishable food and 7 days of non-perishable food. The water temperature measured at 113.7 degrees Fahrenheit to 114.2 degrees Fahrenheit. The bathroom/s are equipped with grab bars, and non-skid floors. Resident's room (R1 to R5) have sufficient storage and are kept sanitary and organized. Facility has housekeeping schedule for each floor and cleaning is done everyday for each resident's unit. page 1 of 2, see LIC 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 The ramps and patio are free from debris and obstruction. The facility were observed to be in good repair.  The laundry is located on the 2rd level of the facility. The facility offers 2 times a week laundry services for free. The facility is equipped with a fire, smoke and carbon monoxide alert system and is maintained by their maintenance person. The hallway are free from obstruction. The fire extinguisher was inspected on 2/12/2024. LPA reviewed 5 out of 34 resident records such as but not limited to the centrally stored medication and destruction record (CSMDR), admission agreement, needs and services plan, health screening and observed that 5 out of 5 resident needs and services plan are not signed by the resident or the responsible party. 5 out of 5 Physician's Report (LIC 602) are not updated since the admission date. Due to insufficient time, LPA will return another day for the annual continuation. No deficiencies were cited per California Code of Regulations, Title 22. This report was reviewed with Director of Staff Development Josephine Almonte and a copy of the report was provided. page 2 of 2 end of report

Licensing Program Analysts (LPAs) Christine Dolores and Davide Hailu arrived unannounced to conduct the facility's Required - 1 Year. LPAs met with Administrator, Travis Clawson. During visit, LPAs toured the facility with Administrator to include the entrance, dining room, kitchen, resident bedrooms, bathrooms, offices, medication rooms, and exterior. All fire exit routes are free and clear of obstruction. Fire extinguishers last serviced on 02/10/2023. Hot water temperature maintained at 108 degrees Fahrenheit. Dining room area is equipped with cups, plates, utensils, and daily menus. Refrigerator temperature maintained at 35 degrees Fahrenheit. Freezer maintained at 0 degrees Fahrenheit. Resident bedrooms supplied with beds, adequate lighting, chair and closet. Bathrooms supplied with toilets, sinks, and showers. Showers equipped with grab bars and shower chairs. LPAs reviewed 5 resident records. Resident records contained physician's report, TB information, appraisal/needs and services plan, consent forms, identification and emergency information, personal rights, and centrally stored medications records. LPAs reviewed 5 staff files. Staff records contained 1st aid certification, job applications, health screening, TB information, and criminal record clearance. 3 out of 5 staff contained a 1st aid certification. Facility has an updated emergency disaster plan. Facility conducts their emergency disaster drills quarterly. Facility is equipped with an emergency disaster kit. First aid kit contains bandages, gauze, tweezers, and scissors. Due to insufficient time, LPA will return another day for the annual continuation. No deficiencies were cited per California Code of Regulations, Title 22. This report was reviewed with Clinical Coordinator, Karen Padilla and a copy of the report was provided.

LPA confirmed that R1 was not and has never been a resident of the facility’s Assisted Living wing. This facility is a Residential Care Facility for the Elderly which contains both an Assisted Living (AL) and Skilled Nursing Facility (SNF). The SNF wing of the facility is not licensed by this department. SNF is regulated by the Department of Public Health. The Department has investigated the above allegations. Based on interviews conducted and documents reviewed, the Department found the above allegations to be UNFOUNDED , meaning that the allegations were false, could not have happened and/or is without a reasonable basis. No deficiencies were cited during today’s visit. An exit interview was conducted with Travis Clawson, Administrator and a signed copy was provided.

Licensing Program Analyst Ryker Heberle (LPA) conducted an unannounced annual inspection on 09/27/2022. LPA met with Administrator Travis Clawson (Admin). LPA entered the facility through the designated central point of entry and was screened by staff. Staff, residents in common areas, and visitors were observed to be wearing face coverings. Hand sanitizers, soap, and paper supplies were observed to be available. At least 30 days' supply of personal protective equipment (PPE) was observed to be available in the premises. LPA toured the with Admin facility. During the tour, LPA observed the temperature to be between 68*F and 78*F in resident bedrooms. Facility water temperature measured at 104.4*F. Fire extinguishers were observed to have been last inspected in February of 2022. Facility was observed to have at least 2 days worth of perishable and one week's supply of nonperishable food. All rooms were observed to be clean and well maintained. All emergency exits observed to be free from obstruction. No prohibited items noted in any resident rooms. The facility has reached a 100% COVID-19 vaccination rate for residents and staff. Smoke and carbon monoxide detectors were observed and confirmed to be operating properly. The facility's infectious control plan has been submitted and is currently under review by the department. No deficiencies were cited. Advisory note was issued. Exit interview conducted with Administrator Travis Clawson and a copy of this report was provided during visit.

LPAs toured the facility and interviewed 4 residents in their rooms. 2 out of 4 residents interviewed stated that the climate controls in their rooms function properly. 1 out of 4 residents stated that the climate controls break often, but that the facility staff always fixes them. 1 out of 4 residents stated that they did not feel like they knew enough to make a determination. 3 out of 4 residents interviewed stated that they believed the facility was providing a safe environment to live in, while 1 out of 4 stated that they did not feel like they knew enough to make a determination. This facility is a Residential Care Facility for the Elderly which contains both an Assisted Living Facility (AL) and Skilled Nursing Facility (SNF). SNF is regulated by the Department of Public Health. The Department has investigated the above allegations. Based on interviews conducted and documents reviewed, the Department found the above allegations to be UNFOUNDED , meaning that the allegations were false, could not have happened and/or are without a reasonable basis. No deficiencies were cited during today’s visit. Exit interview was conducted with Travis Clawson, Administrator and a copy of the signed report was provided.

Admin stated that the new phones were installed one at a time inside resident rooms, and that when old phones ceased to function, they were replaced within a couple days. Admin stated that all CNA's on the facility floor had work phones that residents are allowed to borrow as needed, and that residents have alternate means of telecommunication in the event of personal phone outages. LPAs observed resident phones to currently be functioning properly. LPAs interviewed 4 residents at the facility. 2 out of 4 residents interviewed stated that they have never had issues with their phones. 1 out of 4 residents stated that they have their own cell phone, so they never need to use the facility provided phones. 1 out of 4 residents stated that they did not feel comfortable making a determination. In interviews with facility staff members, 2 out of 2 staff members stated that they always have a work phone when working CNA duties, 2 out of 2 staff stated that they allow residents to use their phones when requested. 2 out of 2 staff stated that in the event of residents not having phones that work, they can push their signals to summon staff to use their phones. The Department has investigated the above allegation. Based on interviews conducted, records reviewed, and LPAs' observations, the Department found the above allegation to be UNSUBSTANTIATED . An unsubstantiated finding indicates that although the allegation may have happened or is valid, there is not a preponderance of evidence to prove that the allegation did or did not occur. Exit interview conducted with Administrator Travis Clawson and a copy of this report was provided.

Alleged perpetrator is a staff at the Skilled Nursing Facility and does not work or cross over to Assisted Living. S1 states the matter was investigated by a few outside agencies in February 2022, to include the California Department of Public Health, Law Enforcement, and the Ombudsman. The Department has investigated the above allegation. Based on interviews conducted and record reviewed, the Department found the above allegation to be UNFOUNDED, meaning that the allegation was false, could not have happened and/or is without a reasonable basis. This report was reviewed with Karen Padilla, Clinical Coordinator and a copy of this report was provided. Page 2 of 2.

The Department has investigated the above allegations. Based on interviews conducted and documents reviewed, the Department found the above allegations to be UNFOUNDED, meaning that the allegations were false, could not have happened and/or is without a reasonable basis. The report was reviewed with Travis Clawson and a copy of this report provided. Page 2 of 2

During review of facility's admission records, LPA confirmed that R1 had no admission history in the facility's assisted living wing. LPA further confirmed via admission records that R1 had been residing in the skilled nursing wing of the facility for over 5 years. LPA confirmed that R1 was not and had never been a resident of the facility’s Assisted Living building. Suspected Abuser (SA) was also confirmed to not have worked in the assisted living facility. This facility is a Residential Care Facility for the Elderly which contains both an Assisted Living (AL) and Skilled Nursing Facility (SNF). SNF is regulated by the Department of Public Health. The Department has investigated the above allegation. Based on interviews conducted and documents reviewed, the Department found the above allegation to be UNFOUNDED , meaning that the allegation was false, could not have happened and/or is without a reasonable basis. No deficiencies were cited during today’s visit. Exit interview was conducted with Travis Clawson, Administrator. This report was reviewed with Travis Clawson, Administrator, and a copy was provided.

On 07/22/2021 at 11:33 am, Licensing Program Analyst (LPA) Anna Bui conducted an unannounced Annual Required 1 Year visit. LPA met with Karen Padilla, Clinical Coordinator. LPA toured the facility beginning with the main entrance. The entrance had a thermometer, hand sanitizer, and sign-in log to document temperature and screening questions. Universal precautions, COVID-19 protocols, and social distancing guidelines were posted throughout the facility. Restrooms had hand soap and paper towels readily available. Hand washing sign was posted at all hand washing stations. Staff and residents were observed wearing a mask and following COVID-19 protocols. Facility observed to have adequate supply of PPE. No deficiencies were cited during today's visit. This report was reviewed with Karen Padilla, Clinical Coordinator, and a copy was provided.

A review of the facility’s records confirmed the alleged victim (R1) was not a resident of the facility’s Assisted Living building. This facility is a Residential Care Facility for the Elderly, and this facility has both an Assisted Living (AL) and Skilled Nursing Facility (SNF). SNF is regulated by the Department of Public Health. The Department has investigated the above allegations. Based on interviews conducted and documents reviewed, the Department found the above allegations to be UNFOUNDED , meaning that the allegation was false, could not have happened and/or is without a reasonable basis. No deficiencies were cited during today’s visit. Exit interview was conducted with Karen Padilla, Clinical Coordinator. This report was reviewed with Karen Padilla, Clinical Coordinator, and a copy was provided.

A review of the facility’s records confirmed the alleged victim (R1) was not a resident of the facility’s Assisted Living building. This facility is a Residential Care Facility for the Elderly, and this facility has both an Assisted Living (AL) and Skilled Nursing Facility (SNF). SNF is regulated by the Department of Public Health. The Department has investigated the above allegations. Based on interviews conducted and documents reviewed, the Department found the above allegations to be UNFOUNDED , meaning that the allegation was false, could not have happened and/or is without a reasonable basis. No deficiencies were cited during today’s visit. Exit interview was conducted with Karen Padilla, Clinical Coordinator. This report was reviewed with Karen Padilla, Clinical Coordinator, and a copy was provided.