Inspection Reports for Sisters Assisted Living
1006 Durant St, Modesto, CA 95350, United States, CA, 95350
Back to Facility ProfileDeficiencies per Year
4
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2
1
0
Severe
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Moderate
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Census Over Time
Census
Capacity
Inspection Report
Annual Inspection
Census: 5
Capacity: 6
Deficiencies: 0
Nov 21, 2024
Visit Reason
The inspection was an unannounced required 1-year annual inspection to ensure compliance with health and safety regulations.
Findings
The facility was found to be clean, odor-free, and in good repair with all required furniture and safety equipment in place. Water temperature and food supplies met regulatory standards, and no deficiencies were cited during the inspection.
Report Facts
Water temperature: 112
Fire extinguisher inspection date: Nov 15, 2024
Inspection start time: 130
Inspection end time: 345
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Jason Lund | Licensing Program Analyst | Conducted the inspection and met with the administrator |
| Karen Fomby | Administrator | Facility administrator who met with the Licensing Program Analyst during the inspection |
Inspection Report
Plan of Correction
Census: 3
Capacity: 6
Deficiencies: 0
May 9, 2024
Visit Reason
The visit was an unannounced proof of correction (POC) inspection to verify correction of a previously cited deficiency from 02/02/2024.
Findings
The Licensing Program Analyst received proper proof of correction documentation and no deficiencies were observed or cited during this visit.
Report Facts
Census: 3
Total Capacity: 6
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Jason Lund | Licensing Program Analyst | Conducted the proof of correction visit |
| Karen Fomby | Administrator | Administrator who gave permission for Care Staff to sign paperwork |
| Princess Major-Banks | Care Staff | Met with Licensing Program Analyst and signed paperwork on behalf of Administrator |
Inspection Report
Complaint Investigation
Census: 3
Capacity: 6
Deficiencies: 0
May 9, 2024
Visit Reason
An unannounced complaint investigation was conducted based on a complaint received on 01/24/2024 regarding allegations about hospice service choices, authorization of hospice transfer requests, and delays in timely hospice services at Sisters Assisted Living Facility.
Findings
The investigation found the allegations unsubstantiated after reviewing records and interviewing the administrator, reporting party, and witnesses. It was unclear if facility staff denied hospice service choices, signed transfer requests without family authorization, or caused delays in hospice services.
Complaint Details
The complaint involved three allegations: 1) Facility staff did not allow a resident a choice of hospice services; 2) Facility staff signed a hospice transfer request form without the resident's family authorization; 3) Facility staff caused delays in residents receiving timely hospice services. All allegations were deemed unsubstantiated based on evidence reviewed.
Report Facts
Estimated Days of Completion: 90
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Jason Lund | Licensing Program Analyst | Conducted the complaint investigation |
| Karen Fomby | Administrator | Facility administrator involved in interviews and findings |
Inspection Report
Complaint Investigation
Census: 5
Capacity: 6
Deficiencies: 1
Feb 22, 2024
Visit Reason
An unannounced complaint investigation was conducted due to an allegation that facility staff abandoned a resident at the hospital.
Findings
The allegation that facility staff abandoned a resident at the hospital was substantiated based on records review and interviews with the administrator, reporting party, and witness. The resident was admitted to the hospital with no responsible party, and the facility had not been paid for services rendered for nine months prior to the resident being dropped off at the hospital with a note left by the licensee.
Complaint Details
The complaint was substantiated. Facility staff abandoned a resident at the hospital. The resident was admitted to the hospital with no responsible party, and the facility had not been paid for services rendered for nine months. The licensee left a note with the resident at the hospital stating non-payment for 9 months.
Severity Breakdown
Type B: 1
Deficiencies (1)
| Description | Severity |
|---|---|
| 87468.1 (a)(1) to be accorded dignity in their person relationships with staff, residents, and other persons. This requirement was not met by: Administrator left a note with resident stating non-payment for 9 months, posing a potential Health, Safety or Personal Rights risk. | Type B |
Report Facts
Estimated Days of Completion: 90
Capacity: 6
Census: 5
Months unpaid: 9
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Karen Fomby | Administrator | Named in investigation and interviews regarding abandonment allegation |
| Jason Lund | Licensing Program Analyst | Conducted the complaint investigation |
| Lisa Rios | Licensing Program Manager | Oversaw complaint investigation |
Inspection Report
Follow-Up
Census: 6
Capacity: 4
Deficiencies: 0
Nov 16, 2023
Visit Reason
The visit was an unannounced proof of correction (POC) inspection to verify correction of two deficiencies cited during the prior visit on 11/3/2023.
Findings
The Licensing Program Analyst received documentation proving correction of the two deficiencies from the previous inspection. An exit interview was conducted with the Administrator and the report was left at the facility.
Report Facts
Deficiencies cited: 2
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Karen Fomby | Administrator | Met with Licensing Program Analyst during the proof of correction visit and exit interview. |
| Jason Lund | Licensing Program Analyst | Conducted the unannounced proof of correction visit and received documentation of correction. |
| Lisa Rios | Licensing Program Manager | Named as Licensing Program Manager on the report. |
Inspection Report
Annual Inspection
Census: 6
Capacity: 4
Deficiencies: 2
Nov 3, 2023
Visit Reason
The inspection was conducted as a required 1 year annual inspection to evaluate the facility's compliance with regulations and ensure the health and safety of residents.
Findings
The facility was generally clean, odor-free, and in good repair with sufficient furniture and lighting. However, two deficiencies were cited: the facility lacked the required liability insurance, and the hot water temperature was measured at 142 degrees Fahrenheit, exceeding the regulatory maximum of 120 degrees.
Deficiencies (2)
| Description |
|---|
| Facility did not have current liability insurance as required by regulations. |
| Hot water temperature measured at 142 degrees Fahrenheit, exceeding the allowed maximum of 120 degrees. |
Report Facts
Hot water temperature: 142
Plan of Correction Due Date: Dec 4, 2023
Plan of Correction Due Date: Nov 17, 2023
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Kevin Gould | Licensing Program Analyst | Conducted the inspection and authored the report. |
| Karen Fomby | Administrator | Facility administrator who met with the Licensing Program Analyst during the inspection. |
Inspection Report
Complaint Investigation
Census: 6
Capacity: 4
Deficiencies: 0
Aug 21, 2023
Visit Reason
An unannounced complaint investigation was conducted in response to allegations received on 04/19/2023 regarding admission agreement signatures, refusal to provide care information, and overcharging of a resident.
Findings
The investigation found the allegations to be unsubstantiated based on records review and interviews with the Administrator, Reporting Party, and witness. It was unclear if staff failed to have the resident's authorized representative sign the admission agreement, refused to provide care information, or overcharged the resident.
Complaint Details
The complaint investigation was unsubstantiated. Allegations included staff not having the resident's authorized representative sign an admission agreement, refusal to provide care information to the authorized representative, and overcharging the resident. The resident's husband had a Durable Power of Attorney for finances but no medical decision authority. The hospital paid the admission fee initially, and the admission agreement was signed by the hospital, not the resident's husband.
Report Facts
Estimated Days of Completion: 90
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Jason Lund | Licensing Program Analyst | Conducted the complaint investigation |
| Karen Fomby | Administrator | Facility administrator interviewed during investigation |
| Stephenie Doub | Licensing Program Manager | Named as Licensing Program Manager on report |
Inspection Report
Annual Inspection
Census: 4
Capacity: 4
Deficiencies: 0
Oct 17, 2022
Visit Reason
An unannounced annual/required inspection was conducted by the Licensing Program Analyst to evaluate compliance with regulations.
Findings
The facility was inspected and found to be in compliance with no violations observed. The environment was safe, clean, and properly equipped with necessary safety devices and supplies.
Report Facts
Census: 4
Capacity: 4
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Karen Fomby | Administrator | Met with Licensing Program Analyst during inspection and participated in exit interview |
| Jason Lund | Licensing Program Analyst | Conducted the annual inspection |
| Stephenie Doub | Licensing Program Manager | Named in the report as Licensing Program Manager |
Inspection Report
Original Licensing
Census: 2
Capacity: 4
Deficiencies: 0
Oct 26, 2021
Visit Reason
The visit was an unannounced Post Licensing and Annual required inspection conducted by Licensing Program Analyst Jason Lund.
Findings
The facility was toured and inspected, including resident rooms, common areas, kitchen, and safety equipment. No violations were observed during the visit, and the facility was found to be in compliance with regulations.
Report Facts
Capacity: 4
Census: 2
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Karen Fomby | Administrator | Met with Licensing Program Analyst during inspection and participated in facility tour |
| Jason Lund | Licensing Program Analyst | Conducted the Post Licensing and Annual required inspection |
Inspection Report
Annual Inspection
Census: 2
Capacity: 4
Deficiencies: 0
Oct 26, 2021
Visit Reason
The inspection was an unannounced required 1-year post licensing and annual inspection conducted by the Licensing Program Analyst.
Findings
The facility was toured and inspected, including resident rooms, common areas, kitchen, and safety equipment. No violations were observed and the facility was found to be in compliance with regulations.
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Karen Fomby | Administrator | Met with Licensing Program Analyst during inspection and participated in exit interview. |
| Jason Lund | Licensing Program Analyst | Conducted the inspection and exit interview. |
| Stephenie Doub | Licensing Program Manager | Named in report header. |
Inspection Report
Original Licensing
Capacity: 4
Deficiencies: 0
Nov 10, 2020
Visit Reason
The visit was a pre-licensing unannounced tele-inspection conducted due to COVID-19 precautionary measures to evaluate the facility prior to licensing.
Findings
No violations were observed during the visit. The facility was found to be in compliance with regulations including proper lighting, cleanliness, safety equipment, locked toxins and sharp objects, and adequate food supply.
Report Facts
Hot water temperature: 110
Supply of perishable foods: 2
Supply of nonperishable foods: 7
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Karen Fomby | Licensee | Met with during inspection and exit interview |
| Treana White | Licensing Program Analyst | Conducted the pre-licensing tele-inspection and Component III presentation |
| Czarrina A Camilon-Lee | Licensing Program Manager | Named in report header |
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