Inspection Reports for Cypress Court

CA, 92026

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Inspection Report Complaint Investigation Census: 159 Capacity: 293 Deficiencies: 1 Nov 25, 2024
Visit Reason
An unannounced visit was conducted to investigate a complaint alleging that the facility roof is in disrepair with leaks affecting resident rooms, the dining room, and hallways.
Findings
The investigation found that although no active leaks were observed during the visit, there was evidence of past leaks including brown spots on the ceiling and a plastic bag taped to a ceiling to contain leaking water. The roof is in disrepair and scheduled for repair in 2025. The allegation was substantiated as the roof leaks pose a potential health, safety, or personal rights risk to residents.
Complaint Details
The complaint was substantiated based on observations, interviews with residents and staff, and record review. Residents reported water leaking through the fire sprinkler in a shared bedroom for the past three years during heavy rains. Staff confirmed a temporary measure of taping a plastic bag to the ceiling to contain leaks. The facility plans to repair the ceiling by 12/09/2024.
Severity Breakdown
Type B: 1
Deficiencies (1)
DescriptionSeverity
87303 Maintenance and Operation (a) The facility shall be clean, safe, sanitary and in good repair at all times. Maintenance shall include provision of maintenance services and procedures for the safety and well-being of residents, employees and visitors.Type B
Report Facts
Capacity: 293 Census: 159 Deficiency POC Due Date: Dec 9, 2024 Number of residents interviewed: 4 Years of leaking reported: 3
Employees Mentioned
NameTitleContext
Janette RomeroLicensing Program AnalystConducted the complaint investigation and authored the report
Tania DupreAdministratorFacility administrator interviewed during the investigation
Ismael DamianMaintenance DirectorIdentified areas affected by roof leaks
Rob JohnstonFacility Administrator named in report header
Inspection Report Follow-Up Census: 159 Capacity: 293 Deficiencies: 1 Nov 25, 2024
Visit Reason
An unannounced case management visit was conducted to address a deficiency observed during a prior complaint investigation, specifically regarding unpaid annual licensing fees.
Findings
The facility had not paid their annual licensing fees due on 07/12/2024 and had an outstanding balance of $4,455.00, which poses a potential health or safety risk to clients in care. The facility will be cited for this deficiency.
Complaint Details
The visit was triggered by a deficiency observed during a complaint investigation.
Severity Breakdown
Type B: 1
Deficiencies (1)
DescriptionSeverity
Failure to pay annual licensing fees due on 7/12/2024, with a current balance of $4,455.00.Type B
Report Facts
Outstanding licensing fees: 4455
Employees Mentioned
NameTitleContext
Janette RomeroLicensing Program AnalystConducted the inspection and authored the report
Tania DupreAdministratorMet with Licensing Program Analyst during inspection
Collette EscalanteBusiness Office ManagerMet with Licensing Program Analyst during inspection
Tricia DanielsonLicensing Program ManagerSupervisor of the inspection
Inspection Report Annual Inspection Census: 161 Capacity: 293 Deficiencies: 0 Jul 25, 2024
Visit Reason
The inspection was an unannounced Required Annual Inspection conducted to evaluate compliance with licensing regulations for the facility.
Findings
The facility was found to be in compliance with all applicable regulations. The physical plant, medication storage, food service, care and supervision, and records were all inspected and found satisfactory with no violations cited.
Report Facts
Facility capacity: 293 Census: 161
Employees Mentioned
NameTitleContext
Tania DupreAdministratorMet with Licensing Program Analyst during inspection and participated in exit interview
Venus MixsonLicensing Program AnalystConducted the inspection and authored the report
Jazmond D HarrisLicensing Program ManagerNamed in report as Licensing Program Manager
Inspection Report Complaint Investigation Census: 150 Capacity: 293 Deficiencies: 0 Dec 14, 2023
Visit Reason
An unannounced complaint investigation visit was conducted following a complaint received on 2020-08-18 alleging that facility staff did not follow a resident's care agreement and physician's orders.
Findings
The investigation found the allegations unsubstantiated due to lack of supporting evidence, as relevant records prior to 2021 were moved off site and no additional information was provided. The preponderance of evidence standard was not met.
Complaint Details
The complaint alleged that staff did not follow Resident 1's care agreement by taking her to the emergency room before contacting the Power of Attorney, and did not follow physician's orders by continuing medication administration beyond the prescribed period. Both allegations were found unsubstantiated.
Report Facts
Complaint received date: Aug 18, 2020 Complaint control number: 08-AS-20200818154152
Employees Mentioned
NameTitleContext
Mark MandelLicensing Program AnalystConducted the complaint investigation visit
Tania DupreAdministratorMet with Licensing Program Analyst during investigation and received investigative findings
Simon JacobLicensing Program ManagerNamed in report as Licensing Program Manager
Inspection Report Annual Inspection Census: 150 Capacity: 293 Deficiencies: 0 Jul 28, 2023
Visit Reason
The visit was an unannounced annual inspection to ensure the facility's compliance with California Code of Regulations, Title 22, Division 6.
Findings
The facility was found to be in good repair with no pathway obstruction, clean and odor-free resident units, working smoke and carbon monoxide detectors, and proper food storage. Staff records and resident interviews revealed no discrepancies. No deficiencies were observed during the inspection.
Report Facts
Food supply duration: 7 Food supply duration: 2 Facility units: 149 Residents approved for hospice care: 10 Non-ambulatory residents capacity: 290 Bedridden residents capacity: 3 Hot water temperature: 117.6 Indoor temperature: 73
Employees Mentioned
NameTitleContext
Jacqueline Shaw RossLicensing Program AnalystConducted the unannounced annual visit and inspection
Collette EscalanteBusiness Office ManagerMet with Licensing Program Analyst and received report
Jazmond D HarrisLicensing Program ManagerNamed as Licensing Program Manager on the report
Inspection Report Complaint Investigation Census: 168 Capacity: 293 Deficiencies: 0 Oct 11, 2022
Visit Reason
The visit was an unannounced case management inspection conducted in response to an incident reported on October 10, 2022, concerning a potential inappropriate relationship between a staff member and a resident.
Findings
No deficiencies were cited during the visit. The Licensing Program Analyst interviewed one staff member and one resident and reviewed pertinent documents.
Complaint Details
The complaint involved a potential inappropriate relationship between Staff #1 and Resident #1. The complaint was investigated during the visit with interviews and document review, and no deficiencies were found.
Report Facts
Capacity: 293 Census: 168
Employees Mentioned
NameTitleContext
Rob JohnstonExecutive DirectorMet with during the inspection
Deanna LyonsResident Services DirectorMet with during the inspection
Tricia DanielsonLicensing Program AnalystConducted the case management visit and investigation
Deborah MullenLicensing Program ManagerNamed in the report header
Inspection Report Census: 167 Capacity: 293 Deficiencies: 0 Aug 5, 2022
Visit Reason
The visit was an unannounced case management incident inspection following receipt of a death report concerning Resident #1.
Findings
No deficiencies were cited during the visit. Licensing staff obtained pertinent documents and toured the facility, concluding with an exit interview and provision of the report copy.
Employees Mentioned
NameTitleContext
Tricia DanielsonLicensing Program AnalystConducted the case management visit and obtained pertinent documents.
Reyna LaceyRegional ManagerConducted the case management visit and obtained pertinent documents.
Donna Daniel-HerrAdministratorFacility administrator met with licensing staff during the visit.
Deanna LyonsResident Care DirectorFacility staff met with licensing staff during the visit.
Inspection Report Annual Inspection Census: 167 Capacity: 293 Deficiencies: 0 Jul 28, 2022
Visit Reason
The Licensing Program Analyst arrived unannounced to conduct an annual inspection with emphasis on infection control.
Findings
The facility was found to be in compliance with COVID-19 mitigation requirements, including appropriate postings, sufficient hygiene supplies, PPE, and an approved COVID-19 Mitigation Plan. No deficiencies were observed during the visit.
Employees Mentioned
NameTitleContext
Rob JohnstonAdministratorMet with Licensing Program Analyst during inspection.
Deeanna LyonsResident Care DirectorMet with Licensing Program Analyst during inspection.
Tricia DanielsonLicensing Program AnalystConducted the annual inspection.
Deborah MullenLicensing Program ManagerNamed in report header.
Inspection Report Complaint Investigation Census: 122 Capacity: 293 Deficiencies: 0 Sep 24, 2021
Visit Reason
The visit was an unannounced complaint investigation triggered by a complaint received on October 7, 2020, regarding a resident's bed being in disrepair.
Findings
The investigation found that the resident's bed was functioning properly after an outside vendor inspection, and staff were shown how to operate the bed's crank system. The allegation was found to be unsubstantiated.
Complaint Details
The complaint alleged that a resident's bed was in disrepair. The investigation included interviews and review of facility records. The resident had passed away in December 2020. The allegation was unsubstantiated due to lack of evidence.
Report Facts
Capacity: 293 Census: 122
Employees Mentioned
NameTitleContext
Adam HamerLicensing Program AnalystConducted the complaint investigation visit
Dennis PrejusaResident Care DirectorMet with the Licensing Program Analyst during the investigation
Denise PowellLicensing Program ManagerNamed in the report as Licensing Program Manager
Inspection Report Complaint Investigation Census: 134 Capacity: 293 Deficiencies: 1 Aug 12, 2021
Visit Reason
An unannounced complaint investigation visit was conducted due to a complaint received on 07/16/2020 alleging that staff did not properly handle food service, specifically that food supposed to be served hot was served cold to residents.
Findings
The investigation found that during the COVID-19 lockdown, residents were served cold food that was supposed to be hot due to logistical challenges and lack of equipment. The allegation was substantiated with evidence including interviews and records review. A citation was issued and a plan of correction was developed.
Complaint Details
The complaint was substantiated. Staff did not properly handle food service during the COVID-19 lockdown, serving cold food instead of hot food to residents. The issue was ongoing and known by staff. A citation was issued in accordance with California Code of Regulations, Title 22.
Severity Breakdown
Type B: 1
Deficiencies (1)
DescriptionSeverity
Facility did not observe procedures which protect the safety, acceptability and nutritive values of food served to residents.Type B
Report Facts
Residents affected: 1 Capacity: 293 Census: 134 Plan of Correction Due Date: Sep 3, 2021
Employees Mentioned
NameTitleContext
Adam HamerLicensing Program AnalystConducted the complaint investigation and authored the report.
Rob JohnstonAdministratorFacility administrator interviewed during the investigation and involved in plan of correction.
Denise PowellLicensing Program ManagerOversaw the licensing program and signed the report.
Inspection Report Annual Inspection Census: 122 Capacity: 293 Deficiencies: 0 Jun 15, 2021
Visit Reason
An unannounced annual required licensing inspection was conducted to verify compliance with statutes, regulations, and infection control practices, including COVID-19 mitigation measures.
Findings
The facility was found to be in compliance with all applicable regulations and infection control practices, including COVID-19 mitigation. No deficiencies were observed during the visit.
Employees Mentioned
NameTitleContext
Rob JohnstonAdministratorPresent during inspection and exit interview
Lisa ChavarriaResident Care DirectorPresent during inspection and exit interview
Adam HamerLicensing Program AnalystConducted the inspection
Denise PowellLicensing Program ManagerNamed in report header
Inspection Report Census: 136 Capacity: 293 Deficiencies: 0 Dec 2, 2020
Visit Reason
The Department conducted the on-site visit to provide technical assistance and to evaluate the facility's disinfection, testing surveillance, screening protocols as well as the use of personal protective equipment.
Findings
During the visit, no deficiencies were issued. The team interviewed the Administrator and Assisted Living Director and conducted a walk-through of the facility.
Employees Mentioned
NameTitleContext
Donna Daniel-HerrAdministratorInterviewed during the visit and discussed purpose of the visit.
Lisa ChavarriaAssisted Living DirectorInterviewed during the visit and discussed purpose of the visit.
Report May 3, 2021
File
report_9_374600378_inx8_2021-05-03.pdf

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