Inspection Reports for Elms Residential Home Care

The inspection was an unannounced required annual visit to evaluate compliance with licensing regulations and ensure the facility meets health and safety standards.

The inspection identified several deficiencies including non-functional fire sprinklers, an outdated and inoperable call button system, incomplete personnel and resident records, lack of documented emergency drills, and missing annual staff training. The facility is undergoing a change of ownership and has plans to correct these deficiencies by specified due dates.

The visit was an unannounced complaint investigation conducted in response to multiple allegations received on 2024-08-09 regarding staff verbal abuse, inadequate food provision, drug activity on premises, resident utilization as staff, and financial abuse of residents.

After interviews with staff and residents and review of records, all allegations were deemed unsubstantiated. Residents confirmed adequate food provision and no verbal abuse or threats by staff. Drug activity allegations were unsubstantiated despite some residents smoking marijuana and one issued an eviction notice. The resident incentive chore program was voluntary and paid. Financial abuse allegations were unsubstantiated with all P&I monies accounted for and no complaints of staff taking money.

The complaint investigation was triggered by allegations of staff verbally abusing and threatening residents, inadequate food provision, failure to prevent drug activity, resident utilization as staff, and financial abuse of residents. All allegations were investigated and found unsubstantiated based on interviews and record reviews.

The inspection was an unannounced required annual visit to the facility conducted by Licensing Program Analysts.

The Licensing Program Analyst conducted interviews, a health and safety tour, and met with staff and the administrator. No deficiencies were cited during this visit.

The visit was conducted as a complaint investigation following an allegation that staff did not provide adequate care and supervision of the residents, including an incident where emergency personnel were summoned for a resident who was unresponsive.

The investigation found insufficient evidence to support the allegation of inadequate care and supervision. Staff were present during the incident, and the resident was found sleeping deeply but easily woken. The allegation was deemed unsubstantiated.

The complaint alleged that staff did not provide adequate care and supervision, citing an incident where emergency personnel were summoned for a resident who appeared unresponsive. The investigation included interviews with staff and residents, observation of staffing schedules, and review of the incident. The allegation was found unsubstantiated due to insufficient evidence.

The inspection was an unannounced complaint investigation visit triggered by allegations received on 2024-01-19 regarding failure to seek medical attention for a resident, failure to notify the resident's responsible person of injury, failure to safeguard confidential records, and failure to clean bedroom floors.

The investigation substantiated all allegations: staff failed to seek timely medical attention for a resident with multiple fractures, did not notify the resident's responsible person of the injury, did not safeguard confidential resident records, and did not maintain cleanliness of resident bedrooms. Observations and interviews confirmed these violations.

The complaint investigation was substantiated. The resident had an unwitnessed fall resulting in multiple fractures that were not timely treated by staff. Staff also failed to notify the resident's responsible person of the injury. Confidential records were accessible to unauthorized persons, and resident bedrooms were found unclean. Multiple interviews and record reviews supported these findings.

The inspection was an unannounced complaint investigation visit triggered by multiple allegations including staff not keeping the facility free of bedbugs, failure to provide emergency personnel resident records, and failure to keep the facility clean and sanitary.

The investigation substantiated that the facility had ongoing bedbug infestations and unsanitary conditions in resident rooms and common areas. Staff failed to provide resident records to emergency personnel during an incident. Other allegations such as questionable death, failure to post the facility license prominently, and insufficient staffing were found unsubstantiated.

The complaint investigation was substantiated for allegations related to bedbug infestation, unsanitary conditions, and failure to provide resident records to emergency personnel. The allegations of questionable death, failure to post the facility license prominently, and insufficient staffing were unsubstantiated.

The visit was conducted as a complaint investigation following an allegation received on 12/21/2023 regarding illegal drug use at the facility.

The investigation found insufficient evidence to support the allegation of illegal drug use at the facility. Interviews with residents, staff, and the administrator denied knowledge of illegal drug use, and the allegation was deemed unsubstantiated.

The complaint alleged illegal drug use at the facility, specifically marijuana and other drugs. The allegation was investigated through interviews and record reviews but was found unsubstantiated due to lack of evidence.

The inspection was an unannounced complaint investigation visit conducted in response to allegations received on 2024-06-24 regarding lack of hot water, insufficient food, forced resident cleaning, and improper cleaning of residents' rooms.

The investigation found insufficient evidence to substantiate any of the allegations. The water heater was broken but promptly replaced restoring hot water within 24 hours. Food quantity was sufficient with three meals and two snacks daily. Residents were not forced to clean; one resident voluntarily collected recycling. Staff were assigned to cleaning duties and rooms were cleaned unless residents refused.

The complaint included allegations that the facility did not have hot water, staff did not ensure enough food for residents, staff made residents clean the facility, and staff were not properly cleaning residents' rooms. All allegations were deemed unsubstantiated based on interviews, observations, and documentation.

The visit was a Case Management visit to discuss the future plans for the facility due to the pending sale of the property.

During the visit, Licensing Program Analysts and Managers interviewed the administrator, reviewed resident files, and participated in a telephone call with other relevant parties. An entrance and exit interview were conducted, and a copy of the report was provided.

The inspection was an unannounced complaint investigation visit triggered by an allegation that the facility electrical panel was malfunctioning.

The investigation confirmed that the facility electrical panel was malfunctioning due to a broken valve and a low battery, which posed a potential health and safety risk. Maintenance staff replaced the broken valve and installed a new battery, and the panel is now operating properly. The allegation was substantiated.

The complaint was substantiated. The allegation was that the facility electrical panel was malfunctioning. The investigation confirmed the issue and corrective actions were taken.

The visit was conducted to meet with the Licensee/Administrator to discuss the potential future closure of the facility and proper closure procedures.

The Licensee was informed about the Health and Safety Code 1569.682 requirements for closure, including the need to submit a closure plan and provide a 60-day notification to residents. The Licensee acknowledged understanding of these requirements and has assistance from a consultant and Ventura County Behavior Health for the closure process.

The inspection visit was conducted to investigate a complaint alleging that the facility had a bedbug infestation.

The investigation found that although there was a bedbug infestation reported in early September 2023, the facility took timely corrective actions including replacing mattresses and pillows, washing bedding, and conducting monthly pest control. At the time of the inspection, no bedbugs or signs of infestation were observed, and the allegation was deemed unsubstantiated.

The complaint alleged a bedbug infestation at the facility. The allegation was investigated through room inspections, resident interviews, and discussions with the pest control company and administrator. The complaint was found to be unsubstantiated as no current infestation was observed.

The inspection was an unannounced complaint investigation visit triggered by an allegation that staff mismanaged residents' medications.

The allegation that staff mismanaged residents' medications was substantiated due to missed medications and failure to provide medication pickup services, with two out of five residents confirming missed doses. A separate allegation regarding facility disrepair, including bed bugs and toilet issues, was investigated and found unsubstantiated.

The complaint was substantiated based on evidence that residents missed medications due to the facility's inability to pick up medications from the pharmacy. Two residents reported missed medications on one occasion. The allegation regarding facility disrepair was unsubstantiated after resident interviews and confirmation of extermination service for bed bugs.

The inspection was an unannounced complaint investigation visit triggered by allegations that residents were not receiving their medications and that there was insufficient staffing to meet residents' care needs.

The allegation that residents were not receiving their medications was substantiated due to a failure to timely order medication for one resident, posing an immediate health risk. The allegation of insufficient staffing was unsubstantiated as observations and resident interviews confirmed adequate staffing to meet needs.

The complaint investigation was substantiated regarding medication administration failures, specifically that one resident did not receive their PRN medication on 9/12/23 due to the facility's delay in ordering. The staffing allegation was unsubstantiated based on interviews and observations.

The inspection was an unannounced required annual visit to evaluate compliance with Title 22 Regulations and ensure health and safety standards at the facility.

The inspection identified multiple deficiencies including expired and improperly labeled food items, unsanitary conditions in resident bedrooms and bathrooms, improper storage of cleaning supplies, expired staff CPR/first aid certifications, missing resident pre-appraisals and admission agreements, lack of quarterly emergency drills, and incomplete medication records.

Unannounced complaint investigation visit conducted due to allegations including insufficient staffing to meet residents' care needs, residents being used as substitutes for required staff, and staff intimidation and retaliation against residents.

All allegations were deemed unsubstantiated based on interviews with residents, staff, and the administrator. Residents reported sufficient staffing and no intimidation or retaliation by staff. Residents volunteer for some household duties but not as substitutes for staff. No deficiencies were observed.

The complaint investigation was triggered by allegations of insufficient staffing, residents substituting for staff, and staff intimidation and retaliation. After interviews and investigation, all allegations were found unsubstantiated.

The inspection was an unannounced complaint investigation visit triggered by an allegation that the facility had an infestation of bed bugs.

The investigation found that while the facility had a past issue with bed bugs, current evidence showed no active infestation. The facility had taken appropriate pest control measures, and the allegation was deemed unsubstantiated.

The complaint alleged a bed bug infestation. After interviews with residents and staff, and review of pest control records, the allegation was found unsubstantiated due to lack of current evidence of infestation.

The inspection was an unannounced complaint investigation visit triggered by allegations received on 2023-05-23 regarding staffing sufficiency, medication administration, and assistance with showers at the facility.

The investigation found all allegations to be unsubstantiated. Residents and staff confirmed that staffing was sufficient to meet resident needs, medications were administered properly, and residents did not require assistance with showers. No deficiencies were observed during the visit.

The complaint investigation addressed three allegations: insufficient staffing to meet resident needs, failure to ensure residents take medications, and lack of assistance with showers. All allegations were deemed unsubstantiated based on interviews and observations.

The inspection was an unannounced complaint investigation visit triggered by allegations received on 2023-04-05 regarding the facility's meal nutrition, laundry services, and dietary needs of residents.

The investigation substantiated that the facility failed to provide adequate fresh fruits and vegetables during meals and did not provide timely basic laundry services due to staffing issues. However, the allegation that staff do not meet residents' dietary needs was unsubstantiated.

The complaint investigation was substantiated for allegations that facility staff do not serve nutritious meals and do not provide basic laundry service. The allegation that staff do not meet residents' dietary needs was unsubstantiated.

The visit was an unannounced Case Management - Deficiencies inspection conducted in conjunction with a subsequent complaint visit to issue citations for deficiencies observed during the complaint investigation that were not related to the complaint.

The licensee failed to comply with the criminal record clearance requirement by not associating staff member S1 to the facility, posing an immediate health, safety, and personal rights risk to persons in care. Civil penalties of $100 were assessed.

The visit was conducted in conjunction with a complaint investigation (Complaint Control #29-AS-20230405151719). The deficiencies cited were not related to the complaint but were observed during the complaint investigation.

The visit was an unannounced Case Management - Deficiencies inspection conducted in conjunction with a complaint investigation to issue citations for deficiencies observed that were not related to the complaint.

The facility was cited for failure to have an administrator or designee present during the visit to assist the Licensing Program Analyst, and staff was unable to provide necessary documentation for the investigation.

The visit was conducted in conjunction with a complaint visit (Complaint Control #29-AS-20230405151719). The deficiencies cited were not related to the complaint.

The inspection was an unannounced complaint investigation visit triggered by an allegation that staff do not provide adequate meal service to residents in care.

The investigation found that the facility did not have a sufficient supply of perishable fruit for the census of 42 residents, and residents confirmed they do not receive fresh fruit every day. Some residents also reported occasionally receiving cold meals. There was no evidence supporting insufficient vegetable supply or breakfast variety complaints.

The complaint was substantiated. The allegation was that staff do not provide adequate meal service, specifically that food was served cold and residents lacked variety in fruits, vegetables, and breakfast items. The investigation confirmed insufficient perishable fruit supply and occasional cold meals.

An unannounced Case Management - Deficiencies inspection was conducted due to a deficiency observed during a complaint investigation.

The facility failed to provide or post a food menu as required by regulations, resulting in a cited deficiency related to general food service requirements.

Inspection was triggered by a deficiency observed during a complaint investigation.

The visit was an unannounced complaint investigation triggered by an allegation that neglect and lack of supervision resulted in a resident injuring another resident.

The investigation found conflicting information regarding the alleged altercation between residents. Staff and resident interviews indicated no physical altercation occurred, only a minor argument that was promptly defused. The allegation was deemed unsubstantiated due to insufficient evidence.

The complaint alleged neglect and lack of supervision leading to a resident injury during an altercation. Interviews revealed no physical fight occurred, only a verbal argument involving a resident and a temporary staff member. The resident refused to disclose details. The allegation was unsubstantiated.

The visit was a Case Management - Deficiencies inspection conducted following a complaint alleging short staffing and unauthorized staff working at the facility.

The inspection found that an individual (I1) worked at the facility without having the required criminal record clearance and fingerprinting, posing an immediate health, safety, and personal rights risk to persons in care. Civil penalties of $100 were assessed.

The complaint investigation revealed the facility was short staffed and an individual without fingerprint clearance was asked to work at the facility and help with laundry. The deficiency was substantiated by record review and interviews.

Unannounced complaint investigation visit conducted due to an allegation of neglect and lack of supervision resulting in a client hitting another client.

The investigation found conflicting accounts of the incident between the involved clients. Staff were not in the immediate area during the incident, and no evidence supported lack of supervision. Residents felt safe and staff reported appropriate intervention practices. The allegation was deemed unsubstantiated.

The complaint alleged neglect and lack of supervision led to Client #1 being hit by Client #2. After interviews with clients, staff, residents, and a case manager, the allegation was found unsubstantiated due to insufficient evidence.

Licensing Program Analyst JoAnn Rosales conducted a Required 1-Year unannounced visit to inspect infection control practices and overall facility compliance.

The inspection found deficiencies including hot water temperature exceeding regulatory limits, accessible disinfectants posing health risks, and inadequate supply of nonperishable fruit. Civil penalties of $250 were issued.

An unannounced complaint investigation visit was conducted in response to an allegation of lack of supervision resulting in a resident being assaulted by another resident.

The Licensing Program Analyst conducted a physical plant inspection and staff interviews. The allegation was deemed unsubstantiated as of the report date.

The complaint investigation was unsubstantiated according to the report delivered on 09/16/2021.

The inspection was an unannounced complaint investigation triggered by an allegation that the Administrator increased rental rates without proper notice.

The investigation found that the Administrator did not provide proper written notice of the rental rate increase to residents, which was a violation of regulation 87507(g)(4). The allegation was substantiated based on interviews and document review.

The complaint was substantiated. The allegation was that the Administrator increased rental rates without proper notice. Interviews and document review confirmed that residents did not receive the required 60 days prior written notice.

The visit was a Case Management - Deficiencies inspection conducted to review compliance with regulations, including admission agreements and medication storage.

The inspection found that several resident admission agreements were incomplete or missing, and medications were not stored securely, posing health risks. Specifically, resident #1's medication was accessible to residents despite the resident being unable to self-administer or store medications.

The inspection was an unannounced complaint investigation triggered by an allegation that facility staff did not provide a resident's medical information to the resident's health care provider.

The investigation found that although the facility initially did not provide exact COVID vaccination dates for resident #1 to the health care provider, the information was later provided. Based on the investigation, the allegation was deemed unsubstantiated.

The complaint alleged that facility staff did not provide resident #1's medical information (COVID vaccination dates) to the resident's health care provider. The allegation was investigated and found to be unsubstantiated.

The inspection was an unannounced complaint investigation triggered by allegations that a resident was intimidating and verbally abusing other residents, and violating house rules by smoking in their room.

The investigation found that the resident did verbally intimidate and verbally abuse staff and residents during behavioral episodes and violated house rules by smoking in their room. However, the allegations were deemed unsubstantiated at this time. The administrator committed to ensuring resident health and safety and to providing staff training on handling behavioral episodes.

The complaint involved allegations that resident #1 intimidated residents, verbally abused residents, and violated house rules by smoking in their room. The investigation concluded the allegations were unsubstantiated.

The inspection was an unannounced complaint investigation visit triggered by an allegation that facility staff did not assist a resident with medications as prescribed.

The investigation substantiated the allegation that staff failed to assist resident #1 with PRN medications as prescribed, specifically Ondansetron 4 mg, which posed an immediate health risk. The facility was cited for not assisting residents with self-administered medications as required.

The complaint was substantiated. The allegation was that facility staff did not assist resident #1 with medications as prescribed, specifically PRN Ondansetron 4 mg. The investigation confirmed missed doses during the PM shift on 1 or 2 days the prior week.

The visit was a Case Management - Deficiencies unannounced inspection conducted to evaluate compliance and address deficiencies at the facility.

During the facility tour, the Licensing Program Analyst observed bleach and bed bug killer stored in an unlocked closet accessible to residents, which posed an immediate health risk. A deficiency was cited for failure to store disinfectants and poisons where inaccessible to clients.

The visit was an unannounced required annual inspection with a specific emphasis on infection control practices and procedures.

The facility was found to be in compliance with Title 22 regulations with no health or safety hazards observed. Infection control practices were adequate, with sufficient PPE supplies and cleaning protocols. No citations were issued during the visit.

An unannounced complaint investigation was conducted due to an allegation that staff failed to keep the facility clean.

The investigation found sufficient evidence to substantiate the allegation that staff failed to keep the facility clean, with multiple residents and staff reporting that rooms and restrooms were not cleaned regularly, posing potential health and safety risks.

The complaint was substantiated. The allegation was that staff failed to keep the facility clean. Interviews with residents and staff confirmed that rooms and restrooms were not cleaned frequently, with some residents reporting their rooms had not been cleaned in 2-3 weeks. Staffing shortages were noted as a contributing factor.