Facility Evaluation Report

Licensing Program Analyst (LPA) Christi Coppo conducted an unannounced visit to facility to open complaint 21-AS-20260416130250. LPA was greeted by caregiver. Administrator Eric Moessing arrived later.

Upon entering the facility LPA observed very strong odor of urine ( deficiency cited, see 809D ). Per caregiver, three (3) residents (R1, R2, and R3) in particular have strong urine odors in their room. LPA toured rooms of said residents and found each room to have a profound and pervasive odor of urine. One resident (R1) in particular had an odor in their room so pervasive it was overpowering. Per caregiver, R1 is very difficult to move so they do not move them very often. LPA discussed with Administrator all three residents and the odor of urine present in their rooms. LPA discussed providing new mattresses or identifying the source of the lingering odor and addressing it with either new items or waterproof protection. This includes any furniture made of cloth material, mattresses, and linens. Per caregiver, R1 refuses to shower, R2 refuses to wear underwear or a brief, and R3 does not like their brief to be changed. All of these reasons led to the state of urine odor within the facility. Per caregiver, they do not have a regularly scheduled incontinence check; if they observe the resident as having a full brief, then they change it. LPA, Administrator and caregiver discussed some options to implement an incontinence check and to chart the checks performed.

Deficiencies cited from the California Code of Regulations, Title 22, Division 6 of California Regulation and the Health and Safety Code. Appeal rights given. Failure to correct the deficiency and/or repeat deficiencies within a 12 month period may result in civil penalties. Exit interview conducted with Administrator and a copy of this report was given.