306000295-5-6-2024-22-AS-SSAS-D5HQ37-20240522114817

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 306000295
Report Date: 05/06/2024
Date Signed: 05/06/2024 03:25:21 PM

Unsubstantiated

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
ORANGE COUNTY RO, 770 THE CITY DR., SUITE 7100
ORANGE, CA 92868

This is an official report of an unannounced visit/investigation of a complaint received in our office on
02/09/2024 and conducted by Evaluator Kevin Saborit-Guasch

PUBLIC

COMPLAINT CONTROL NUMBER: 22-AS-20240209141147

FACILITY NAME:	KARLTON RESIDENTIAL CARE CENTER		FACILITY NUMBER:	306000295
ADMINISTRATOR:	ELENA WEINER		FACILITY TYPE:	740
ADDRESS:	3615 WEST BALL RD.		TELEPHONE:	(714) 236-1170
CITY:	ANAHEIM	STATE: CA	ZIP CODE:	92804
CAPACITY:	76	CENSUS: 48	DATE:	05/06/2024
		UNANNOUNCED	TIME BEGAN:	01:00 PM
MET WITH:	Elena Weiner, Executive Director		TIME COMPLETED:	03:30 PM

ALLEGATION(S):

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Staff are not following infection control practices

Staff failed to provide adequate incontinence care to a resident

INVESTIGATION FINDINGS:

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On this day, Licensing Program Analyst (LPA) Kevin Saborit-Guasch made an unannounced visit to the facility for the purpose of following up on the investigation of the two allegations listed above. LPA was greeted and granted entry by facility staff after explaining the purpose of the visit. Administrator Elena Weiner was present on the premises and assisted with the visit.

An initial complaint investigation visit was held on February 13, 2024. LPA accompanied by administrator conducted a tour of the facility's physical plant including a dedicated unit currently in place after a total of 18 residents tested positive for COVID starting on or around February 5th, 2024. LPA reviewed resident clipboards maintained for residents flagged with risks of skin breakdown due to the use of incontinence supplies and was provided a list of residents being provided with incontinence supplies.

CONTINUED ON FORM LIC9099-C

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Sheila Santos	TELEPHONE: (714) 334-2062
LICENSING EVALUATOR NAME: Kevin Saborit-Guasch	TELEPHONE: (714) 497-8754
LICENSING EVALUATOR SIGNATURE:	DATE: 05/06/2024

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/06/2024

This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC9099 (FAS) - (06/04)

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Control Number 22-AS-20240209141147

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
ORANGE COUNTY RO, 770 THE CITY DR., SUITE 7100
ORANGE, CA 92868

FACILITY NAME: KARLTON RESIDENTIAL CARE CENTER	FACILITY NUMBER: 306000295
	VISIT DATE: 05/06/2024

NARRATIVE

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CONTINUED FROM LIC9099
During the follow-up visit, LPA conducted or attempted interviews with five residents out of the 49 currently admitted individuals, multiple of which were among the residents who tested positive during the COVID outbreak reported in February 2024.

Regarding the allegation that Staff are not following infection control practices, the following has been concluded: During the walk-through of the facility conducted on February 13, 2024, LPA observed that all residents who had tested positive had been put in isolation in a clearly identified wing of the facility. The use of Personal Protection Equipment was confirmed and disposal bins for donning and doffing were observed at both exits of the isolation section of the facility. It was also confirmed that facility had reported the cases as required and solicited guidance from the local public health authority and used that guidance to manage the outbreak. The presence of COVID-positive residents was confirmed to be notified to potential visitors and marked throughout the facility.

Regarding the allegation Staff failed to provide adequate incontinence care to a resident, the following has been concluded: during the walk-through of the facility's physical plant as well as during interviews conducted during the present visit, LPA observed residents were clean, well-kept and that the facility was free of odors associated with the failure to manage incontinence. Interviews conducted failed to corroborate a failure to provide adequate incontinence care to the residents. Furthermore, records reviewed during the visit demonstrated the presence of a surveillance system designed to ensure the adequate monitoring of residents with incontinence issues.

As a result, both allegations are found to be Unsubstantiated, meaning that although the allegations may have happened or are valid; there is not a preponderance of evidence to prove that the alleged violations did or did not occur.

An exit interview was conducted, and this report was reviewed with Executive Director. A copy of this report was provided to a facility representative.

SUPERVISOR'S NAME: Sheila Santos	TELEPHONE: (714) 334-2062
LICENSING EVALUATOR NAME: Kevin Saborit-Guasch	TELEPHONE: (714) 497-8754
LICENSING EVALUATOR SIGNATURE:	DATE: 05/06/2024

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/06/2024

LIC9099 (FAS) - (06/04)

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