336412449-2-21-2024-18-AS-SMAZ-D2NUQZ-20240221144758

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 336412449
Report Date: 02/21/2024
Date Signed: 02/21/2024 02:48:16 PM

Document Has Been Signed on 02/21/2024 02:48 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
RIVERSIDE ASC, 1650 SPRUCE ST STE 200 MS29-27
RIVERSIDE, CA 92507

FACILITY NAME:	GUIDING HANDS, RCFE		FACILITY NUMBER:	336412449
ADMINISTRATOR:	LUCIDA JOCSON		FACILITY TYPE:	740
ADDRESS:	29238 GLENCOE LANE		TELEPHONE:	(951) 246-3699
CITY:	MENIFEE	STATE: CA	ZIP CODE:	92584
CAPACITY:	6	CENSUS: 5	DATE:	02/21/2024
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	08:17 AM
MET WITH:	Luz Price, Administrator		TIME COMPLETED:	03:00 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), Stephanie Martinez, conducted an unannounced visit to the facility to complete a required annual inspection. The LPA met with Administrator, Luz Price, and informed her of the purpose for her visit. Facility Records: The LPA reviewed the facility's records; missing information was observed. The LPA did not observe an infection control plan to be available. Staff Records: The LPA reviewed the staff records; missing and/or incomplete information was observed. The LPA did not observe personnel files available for the Licensees, Lucida and Federico Jocson. According to Licensee, Lucida, her file and that of Licensee Federico were stolen by a previous staff member several years ago. She stated the personnel records had not been recreated. The Licensee reported the files would be recreated and a plan would be developed to ensure they are available for review. The LPA reviewed staff training. According to Administrator Price, Licensee, Lucida, provided training to staff in emergency procedures three months ago; however, no proof of the training was available. Training requirements for dementia care, postural supports, restricted health conditions, and hospice care were not observed on file for Staff Two (S2) or Three (S3). According to Administrator Price, previous dementia training may have been provided two years ago. According to the Administrator, hospice training was provided to S2 and S3; however, documentation was not completed. According to the Administrator, training was not provided to staff for postural supports or restricted health conditions. In addition, no initial or annual medication training was observed on file for S2. According to the Administrator, S2 does administer medications. Some initial medication training was observed for S2; however, the training was provided by another facility on 06/24/2008, which does not meet regulatory requirements. Resident Records: The LPA reviewed resident records; missing and/or incomplete information was observed. Names, addresses, and telephone numbers for resident's dentists was not observed to be readily available for

SUPERVISOR'S NAME: Rikesha Stamps	TELEPHONE: (951) -212-0616
LICENSING EVALUATOR NAME: Stephanie Martinez	TELEPHONE: (951) 204-5924
LICENSING EVALUATOR SIGNATURE:	DATE: 02/21/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/21/2024

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
RIVERSIDE ASC, 1650 SPRUCE ST STE 200 MS29-27
RIVERSIDE, CA 92507

FACILITY NAME: GUIDING HANDS, RCFE	FACILITY NUMBER: 336412449
	VISIT DATE: 02/21/2024

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any residents in care. No Pre-Admission Appraisal was observed on file for Resident Three (R3), Four (R4), or Five (R5). A resident appraisal was observed on file for Resident One (R1) and Two (R2), though, the document was incomplete. Admission agreements were also reviewed and found to be incomplete for R1, R2, R3, R4 and R5. The required contact information for Community Care Licensing (CCL) and the Long Term Care Ombudsman (LTCO) was not observed in the residents agreements. In addition, no written record of care was observed on file for R1 or R2. R4 had their original written record of care; however, it was not updated within the required 12 month time period. According to the Administrator, there is no current written record of care for R1, R2 or R4. The Administrator stated she was not aware a written record of care had to be established for any residents who were not receiving hospice services. When reviewing resident hospice files the LPA observed no hospice care plan for R3. According to Administrator, R3 does not have a current hospice care plan due to recently being placed on hospice in January 2024.

Staff interviews: The LPA completed two staff interviews. S3 was unable to provide answers relating to resident healthcare needs, personal rights, medication, or abuse reporting.

Due to insufficient time, a follow up visit will be conducted to address the listed violations. Administrator stated neither S1 or S2 will administer medication until training is provided.

An exit interview was conducted; this report was reviewed with Administrator Price and a copy was provided.

SUPERVISOR'S NAME: Rikesha Stamps	TELEPHONE: (951) -212-0616
LICENSING EVALUATOR NAME: Stephanie Martinez	TELEPHONE: (951) 204-5924
LICENSING EVALUATOR SIGNATURE:	DATE: 02/21/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/21/2024

LIC809 (FAS) - (06/04)

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