Alameda House

Published
0.000
Contact Information
Licensee Name
The Solidarity Fellowship, Inc.
34401 and 34413 Blackstone Way, Fremont, CA 94555
Facility Name
Identification Number
010019AN
Reviews & Findings
Dates of Review
14-Jul-16
Type of Review
COMPLIANCE REVIEW
Deficiencies

1. Title 9, Section 10513 Adherence to Express Conditions of Licensure Class B

The above section states, ”4 licensee shall not operate a facility beyond the conditions and limitations specified on the license.”

The licensee was deficient in meeting this regulation because a 15th bed was found in the garage at 34401 Blackstone Way. The facility is approved for a 14 bed residential program only.

2. Title 9, Section 10563 Accountability Class B

The above section states, “The licensee, whether an individual or other entity is accountable for the general supervision of the licensed facility and for the establishment of policies concerning its operation.”

The Licensee was deficient in meeting this regulation because a bottle of brandy was found in the linen closet at 34401 Blackstone Way.

***This deficiency was corrected onsite***

The licensee was deficient in meeting this regulation because two prescription bottles (one containing medication) were found in bedroom #1 at 34413 Blackstone Way.

3. Title 9, Section 10564(c) Personnel Requirements Class C

The above section states “In addition to the requirements of (b) of this regulation, program staff who provide counseling services shall be licensed, certified or registered to obtain certification.”

The licensee was deficient in meeting this regulation because personnel files did not contain current registration/certification credentials for Employees #1 and #2.

4. Title 9, Section 10564(e) (1) Personnel Requirements Class B

The above section states, in part, “All personnel shall be in good health, good physical health shall be verified by a health screening, including a test for tuberculosis, performed under licensed medical supervision not more then sixty (60) days prior or seven (7) days after employment with tuberculosis testing renewable every year.”

The licensee was deficient in meeting this regulation because there was no documentation that a tuberculosis test had been administered to Employee within the past year.

5. Title 9, Section 10564(k) Personnel Records Class C

The above section states, “The licensee shall develop, maintain, and implement an ongoing training program for all staff in the areas identified in section 10564(b)(3) of this sub chapter in addition to specific training related to their duties. Staff participation in the training program shall be documented and maintained on file for three (3) years. ”

The licensee was deficient in meeting this regulation because there was no documentation of an ongoing training program in any of the personnel records reviewed.

6. Title 9, Section 10564(1}(1)(2) Personnel Records Class C

The above section states, “The licensee shall maintain personnel records for all staff, including program administrators, containing: (1) Name, address, telephone number, position, duties, and date of employment; and (2) Resumes, applications, and/or transcripts documenting work experience and/or education used to meet the requirements of this regulation.”

The licensee was deficient in meeting this regulation because the resume I work experience information for Employee#3 was not contained in the personnel record.

The licensee was deficient in meeting this regulation because the job description / duty statement for Employees#2 and #3 were not contained in the personnel record.

The licensee was deficient in meeting this regulation because the employment date for Employee #2 was not contained in the personnel record.

The licensee was deficient in meeting this regulation because the personnel record for Michael Shinkel was not made available for review.

7. Title 9, Section 10566(b)(2)(A) Admission Agreements Class C

The above section states, “The licensee, whether an individual or other entity, is accountable for the general supervision of the licensed facility and for the establishment of policies concerning its operation.”

The licensee was deficient in meeting this regulation because a bottle of brandy was found in the linen closet at 34401 Blackstone Way.

***This deficiency was corrected onsite.***

The licensee was deficient in meeting this regulation because two prescription bottles (one containing medication) were found in bedroom #1 at 34413 Blackstone Way.

Deficiencies 2

8. Title 9, Section 10567(a) Resident Health Screening Class B

The above section states, “Every resident shall complete a health questionnaire which shall identify any health problems or conditions which require medical attention, or which are of such a serious nature as to preclude the person from participating in the program.”

The licensee was deficient in meeting this regulation because health screening questionnaires were not contained in Resident and files for review.

9. Title 9, Section 10568{b)(8) Resident Records Class B

The above section states, “Each record shall contain information including, but not limited to the following: Record of any permitted current medication, including the name of the person who prescribed the medication and instructions for its use.”

The licensee was deficient in meeting this regulation because the licensee does not maintain a record of permitted medications.

10. Title 9, Section 10572(b) Health-Related Services Class B

The above section states, in part, “During the provision of alcoholism or drug abuse recovery or treatment services a defined in section 10501(a) of this sub chapter there shall be at least one person in the facility who is capable of providing cardiopulmonary resuscitation and first aid, notwithstanding section 10572(b)(1) of this sub chapter.

The licensee was deficient in meeting this regulation because the first aid certification for Employees #1, #2, and #3 had expired.

The licensee was deficient in meeting this regulation because the CPR certification for Employee #1 had expired.

The licensee was deficient in meeting this regulation because there was no documentation that Employees #2 and #3 had completed CPR certification.

Deficiencies 3

11. Title 9, Section 10573(a) Food Service Class B

The above section states, in part:
1. All food shall be selected, stored, prepared and served in a safe and healthful manner.
7. All foods shall be selected, transported, stored prepared and served so as to be from contamination and spoilage and shall be fir for human consumption. Food in damaged containers shall not be accepted, used or retained.
14. All foods or beverages capable of supporting rapid and progressive growth of microorganisms which can infect or intoxicate food shall be stored in covered containers at 45 degrees Fahrenheit (7.2 degrees Celsius) or less.
16. Soaps, detergents, cleaning compounds or similar substances shall be stored in areas separate from food supplies.
17. All kitchen, food preparation, and storage areas shall be kept clean, free from litter and rubbish.
18. All food shall be protected against contamination. Contaminated food shall be discarded immediately.
19. All equipment, fixed or mobile, dishes and utensils shall be kept clean, and maintained in good repair.

The following deficiencies were found at the 34401 Blackstone Way location:

*The licensee was deficient in meeting this regulation because food in the refrigerator had expired. For example a bottle of mustard had expired on 12/20/2015 and a jar of apple sauce expired on 6/6/2015
* The licensee was deficient in meeting this regulation because the food pantry and oven were dirty.
* The licensee was deficient in meeting this regulation because the thermometer in the refrigerator was broken. Therefore, it cannot be determined if the temperature inside the refrigerator was 45 degrees or less.
* The licensee was deficient in meeting this regulation because bottle cleaning compound was stored next to the food in the dining room.

12. Title 9, Section 10581(a) Buildings and Grounds Class C

The above section states, “Facilities shall be clean, safe, and sanitary and in good repair at all times for the safety and well-being of residents, employees and visitors.”

*The licensee was deficient in meeting this regulation because the carpet in the living room was dirty.
*The licensee was deficient in meeting this regulation because there was no battery in the fire alarm.
*The licensee was deficient in meeting this regulation because food and beverage were being store in the bedrooms #1 and #3.
*The licensee was deficient in meeting this regulation because the window blinds were damaged in bedroom #2.
*The licensee was deficient in meeting this regulation because there were exposed wires along the window in bedroom #3.
*The licensee was deficient in meeting this regulation because gym equipment is being stored in the backyard.
*The equipment is rusted/ damaged and not suitable for use.
* The licensee was deficient in meeting this regulation because the barbecue in the backyard was dirty.

The following deficiencies were found at the 34413 Blackstone Way location:

* The licensee was deficient in meeting this regulation because the cabinet in the kitchen was broken.
* The licensee was deficient in meeting this regulation because the tile by the refrigerator was cracked.
* The licensee was deficient in meeting this regulation because the couches in the living room were soiled.
* The licensee was deficient in meeting this regulation because the window blinds were broken in the living room.
*The licensee was deficient in meeting this regulation because food was being stored in bedrooms #1, #2 and #3.
* The licensee was deficient in meeting this regulation because the the air vent was dirty in bedroom #2.
* The licensee was deficient in meeting this regulation because cobwebs were present in bedroom #3.
* The licensee was deficient in meeting this regulation because the closet door was cracked in bedroom #3.

Deficiencies 4

13. Title 9, Section 10581(a) (1) Fixtures, Furniture, Equipment and Supplies Class C

The above section states, “Facilities shall be clean, safe and sanitary and in good repair at all times for the safety and well-being of residents, employees and visitors. The licensee shall take measures to keep the facility free of flies and other insects.”

The licensee was deficient in meting this regulation because a spider was present in bathroom #2 at 34413 Blackstone Way.

14. Title 9, Section 10584(b) Fixtures, Furniture, Equipment and Supplies Class C

The above section states, “All window screens shall be in good repair and free of insects, dirt and other debris.”

The licensee was deficient in meeting this regulation because the windowsill of bedroom #2 was dirty at 34401 Blackstone Way.

The licensee was deficient in meeting this regulation because the windowsills of bedrooms #1 and #2 were dirty at 34413 Blackstone Way.

15. Title 9, Section 10584(c) Fixtures, Furniture, Equipment and Supplies Class C

The above section states, “the licensee shall provide lamps or lights as necessary in all rooms and other areas to ensure the safety of all persons in the facility.”

The licensee was deficient in meeting this regulation because appropriate lighting was not provided in bedroom #1 at 34401 Blackstone Way.

The licensee was deficient in meeting this regulation because the lamp in the living room at 34413 Blackstone Way was not working.

The license was deficient in meeting this regulation because a light bulb was missing from the light fixture in the dining room.

Deficiencies 5

16. Title 9, Section 10584(e) Fixtures, Furniture, Equipment and Supplies Class C

The above section states, ”All toilets, hand washing and bathing facilities shall be maintained in safe and sanitary operating conditions.”

The following deficiencies were found at the 34401 Blackstone Way location:

* The licensee was deficient in meeting this regulation because The licensee was deficient in meeting this regulation
*The licensee was deficient in meeting this regulation because the medicine cabinet in bathroom #2 was rusted.
* The licensee was deficient in meeting this regulation because cobwebs were present in bathroom #1.

The following deficiencies were found at the 34413 Blackstone Way location:

*The licensee was deficient in meeting this regulation because cobwebs were present in bathroom #1.
*The licensee was deficient in meeting this regulation because the shower floor of bathroom #2 was dirty.
*The licensee was deficient in meeting this regulation because there were cracks in the shower wall of bathroom #2.

17. Title 9, Section 10584(f)(1) Fixtures, Furniture, Equipment and Supplies Class C

The above section states, “Solid waste shall be stored, ,located and disposed in such a manner that will not transmit communicable diseases, emit odors, create a nuisance, or provide a breeding place or food source for insects or rodents. Ali containers, including movable bins, used for storage of solid waste shall have tight fitting covers that are kept in place. The containers and covers shall be in good repair, leak proof, and rodent proof.”

The licensee was deficient in meeting this regulation because all containers used for storage of solid waste in both kitchens did not contain covers.

18. Title 9, Section 10584(g) Fixtures, Furniture, Equipment and Supplies Class C

The above section states, “The licensee shall provide clean linen in good repair, including lightweight, warm blankets, top and bottom bed sheets, pillow cases, mattress pads, bath towels, and wash cloths.”

The licensee was deficient in meeting this regulation because mattress pads were missing from each bed at 34401 Blackstone Way.

The licensee was deficient in meeting this regulation because mattress were missing from six out of seven beds at 34413 Blackstone Way.

Detailed Information
Census Data

TOTAL OCCUPANCY:
Approved: 14
Census: 15

TREATMENT CAPACITY:
Approved: 12
Census: 12