331880511-5-24-2022-18-AS-CCON-CEQRJM-20220524130411

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 331880511
Report Date: 05/24/2022
Date Signed: 05/24/2022 01:04:23 PM

Document Has Been Signed on 05/24/2022 01:04 PM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1650 SPRUCE ST STE 200 MS29-27
RIVERSIDE, CA 92507

FACILITY NAME:	PALMS AT LA QUINTA, THE		FACILITY NUMBER:	331880511
ADMINISTRATOR:	PATRICK MCADOO-MORTON		FACILITY TYPE:	740
ADDRESS:	45160 SEELY DRIVE		TELEPHONE:	(760) 345-5353
CITY:	LA QUINTA	STATE: CA	ZIP CODE:	92253
CAPACITY:	120	CENSUS: 88	DATE:	05/24/2022
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	12:00 PM
MET WITH:	Roland Gandy - Administrator		TIME COMPLETED:	01:15 PM

NARRATIVE
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	Licensing Program Analyst (LPA) Crystal Colvin arrived at the facility unannounced for the purpose of completing the facility's Annual Inspection. LPA Colvin met with Administrator Roland Gandy and advised of the purpose of the visit, and that the Annual Inspection will be limited to Infection Control only. Below is a summary of what was observed: Infection Control: LPA Colvin went over COVID-19 best practices for infection control and prevention with Administrator Roland Gandy, and reviewed the facility's Mitigation Plan. Residents have hand sanitizer available to them (through staff in Memory Care and individually in Assisted Living), and the bathrooms were stocked with hand soap and paper towels. Upon entering the facility, LPA Colvin had her temperature taken and filled out a questionnaire regarding COVID symptoms. LPA Colvin viewed the facility's PPE supplies (gloves, masks, and sanitizer, and isolation gowns) which LPA Colvin determined to be sufficient for a 30-day supply. These PPE supplies are accessible to staff in both a dedicated storage room. LPA Colvin went over the various recommended training for facility staff with Administrator Roland Gandy in relation to COVID-19 and confirmed that staff have been trained on various aspects of infection control, recognition of symptoms of COVID-19, and donning/doffing PPE. Administrator Roland Gandy informed LPA Colvin that staff have not yet been fit tested for N95 masks, but that the facility is in the process of getting this completed within the next two weeks. LPA Colvin will be issuing a Technical Assistance Advisory Note during today's inspection for staff not being fit tested for N95 masks. LPA Colvin will not be issuing a deficiency for this item due to the facility not currently having any COVID-19 positive residents, and N95 masks only needing to be worn when a resident is COVID-19 positive or under observation while awaiting test results. Administrator Roland Gandy confirmed that staff are continuing to monitor residents’ symptoms, and that both staff and visitors are screened for COVID-19 symptoms prior to entering the facility. LPAs Colvin additionally observed a sign-in log for visitors, where their temperature is recorded as well as answers to screening questions.

SUPERVISOR'S NAME: Joel Esquivel	TELEPHONE: (951) 248-0312
LICENSING EVALUATOR NAME: Crystal Colvin	TELEPHONE: (951) 204-0848
LICENSING EVALUATOR SIGNATURE:	DATE: 05/24/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/24/2022

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

LIC809 (FAS) - (06/04)

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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1650 SPRUCE ST STE 200 MS29-27
RIVERSIDE, CA 92507

FACILITY NAME: PALMS AT LA QUINTA, THE	FACILITY NUMBER: 331880511
	VISIT DATE: 05/24/2022

NARRATIVE

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Other:
During LPA Colvin's inspection, LPA Colvin observed that Administrator Roland Gandy was not on the facility's staff roster, which LPA Colvin had pulled from Guardian this morning. LPA Colvin additionally contacted Licensing Office staff to have them double check the Administrator's clearance status, and confirmed that while Roland Gandy is cleared, he is not associated to any facility.

Having someone working at the facility without completion of transferring clearance results in civil penalties in the amount of $100 per day, per individual. Since this is the facility's first citation for this in the last 12 months, the maximum amount of days they can be cited is 5. LPA Colvin will be issuing civil penalties in the maximum amount of $500 ($100 per day x 5 days) during today's inspection, as Administrator Roland Gandy has been working at the facility since February 2022.

An exit interview was conducted with Administrator Roland Gandy and a copy of this report, LIC809D, LIC421(BG) and appeal rights were provided.

SUPERVISOR'S NAME: Joel Esquivel	TELEPHONE: (951) 248-0312
LICENSING EVALUATOR NAME: Crystal Colvin	TELEPHONE: (951) 204-0848
LICENSING EVALUATOR SIGNATURE:	DATE: 05/24/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/24/2022

LIC809 (FAS) - (06/04)

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Document Has Been Signed on 05/24/2022 01:04 PM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1650 SPRUCE ST STE 200 MS29-27
RIVERSIDE, CA 92507

FACILITY NAME: PALMS AT LA QUINTA, THE	FACILITY NUMBER: 331880511
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 05/24/2022

DEFICIENCIES & PLANS OF CORRECTION (POCs)

Type A

Section Cited

CCR

87355(e)(2)

Criminal Record Clearance: (e) All individuals subject to a criminal record review pursuant to Health and Safety Code Section 1569.17(b) shall prior to working, residing or volunteering in a licensed facility: (2) Request a transfer of a criminal record clearance as specified in Section 87355(c) This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on record review, the licensee did not comply with the section cited above with one staff member (Administrator) which poses an immediate safety risk to persons in care.
	POC Due Date: 05/25/2022
	Plan of Correction
1 2 3 4	Licensee agrees to have Administrator Roland Gandy associated to the facility and submit an Administrator Packet to Community Care Licensing Riverside Regional Office for review and processing. Licensee to provide LPA Colvin with proof of submission of packet and association of Administrator to facility by Plan of Correction date of 5/25/22

Section Cited


	Deficient Practice Statement
1 2 3 4
	POC Due Date:
	Plan of Correction
1 2 3 4

Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.

SUPERVISOR'S NAME: Joel Esquivel	TELEPHONE: (951) 248-0312
LICENSING EVALUATOR NAME: Crystal Colvin	TELEPHONE: (951) 204-0848
LICENSING EVALUATOR SIGNATURE:	DATE: 05/24/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/24/2022

LIC809 (FAS) - (06/04)

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