10 a 2 13 1“ 15 16 uv 18 as 20 a 22 23 24 2s 26 27 LEGAL DIVISION Department of Social Services ice of General Counsel /SHIRLEY D. RAMIREZ “Assistant Chief Counsel NANA CHIN, State Bar No, 224600 ‘Senior Stati Attorney. '1000 Corporate Center Drive, Suite 670 Monterey Park, CA 91754 Telephone Number; (333) 980-4898 Facsimite Number: (823) 981-3433. Attorneys for Complainant BEFORE THE DEPARTMENT OF SOCIAL SERVICES ‘STATE OF CALIFORNIA IN THE MATTER OF: THE BREAKERS OF LONG BEACH | CDSS No. 6214041301 210 E. Ocean Blvd. OAH No, Long each, CA 96802 ‘SECOND AMENDED ACCUSATION (icense Revocation) DAN COOPER, CDSS No. 62140413018 SECOND AMENDED ‘ACCUSATION Respondent. | (Revocation oF Administrator rlficate) ISDICTION 1. This matter arises under the California Residential Care Facilities for the Elderly Act, Health and Safety Code section 1569 et soq,, which governs the licensing {and operation of residential care facitios for the elderiy 2. The reguiations which govern the lleensing and operation of residential care faites forthe elderly are contained in California Code of Regulations, tle 22, section 87100 et seq ln Sibseuet ences o ay repute scone) at Ti 2c he Calor Cote of Repo administator docert and leonse revo doc 13. The California Department of Social Services (‘Department") is the 2 || agency of the State of Califomia responsible for the liconsing and inspection of 3 || residential care taciities for the elderiy and for cortilying individuals to be administrators 4 [of residential care tacilties forthe elderly 5 4. Administrative proceedings before the Department must be conducted in 6 || conformity with the provisions of the California Administrative Procedure Act, Chapter 5, 7 || Government Code section 11500 et seq. 8 5. Pursuant to Health and Safety Code section 1569.52, the Department 9 || may Insitute oF continue a discipinary proceeding against a licensee following the 20 || suspension, expiration, or forfeiture ofa license and may revoke or deem forfeited the 12 |] certificate of an administrator pursuant to Health and Safety Code section 1569.616(h) 12 || and Regulation section 87408(a) 2 6. Pursuant to Heath and Safety Code section 1569.51(b), the standard of 14 || proof to be applied inthis proceeding is the preponderance of evidence, as THE PARTIES 16 7. Complainant PAMELA DICKFOSS is the Deputy Director of the 17 || Community Care Licensing Division of the Department, Pursuant to Government 18 || Code section 11503, Complainant files this Second Amended Accusation 19 || Accusation”) in her official capacity. 20 8. Respondent THE BREAKERS OF LONG BEACH (‘Respondent 21 || Breakers’ isicensed by the Department to operate a residential care facility for the 22 || elderly at 210 E. Ocean Boulevard, Long Beach, California 90802 (acilty’). The facil 23 || was intially licensed on June 25, 1998. A copy of Respondent Breakers’ most recent 24 || icense seting forth the capacity, imitations, and effective dates accompanies this 25 || Accusation as ATTACHMENT A and is incorporated by reference. 26 9. Respondent DAN COOPER (‘Respondent Cooper’) was certiied on July 27 || 26, 2012, to be a residential care facilly for the elderly administrator. A copy of administrator docort and Hens reve.doo 21 || Respondent Cooper's most recent administrator certificate accompanies this Accusatio 2 [jas ATTACHMENT B and is incorporated by reference. 3 10. Respondent Breakers and Respondent Cooper (hereatter collectively, Respondents’), by vue of icensure and administrator certification, must operat in 5 |] accordance with the statutes and regulations governing the ficonsing and operation of 6 || residential care facilties for te elderly. Copies ofthe applicable statutes and regulations accompany this Accusation as ATTACHMENT C and are incorporated by 8 |) roferonce. 9 FACTUAL ALLEGATIONS 20 ||SuBJECT MATTER: FAILURE TO PROVIDE BASIC CARE 11 ||APPLICABLE LAW: Health and Safety Code sections 1569.2, 1569.912, 2 1569,50(a)-(¢), 1569.725 and 1569.74 Bb Regulation sections 87465(a)(1)(2), (a), 87466, “ 87468(a)(16), 87469(c), 87612(a)(11), 87613, 87691 and as 87758 16 || ALLEGATIONS: uv 11. From approximately September 7, 2012 to October 8, 2012, 18 | Respondents failed to provide basic care to mest the condition and needs of Resident 19 ||No. 1, a8 follows: ‘A. On or about October 2, 1012, Respondent Breakers refused to 21] oliow the wound care instructions provided by St. Mary's Medical Center forthe 22} wound Resident No, 1 sustained atthe facility on Septomiver7, 2012. aa | 8B. Respondent Breakers failed fo comply with Resident No. 1's 24] September 7, 2012, doctor's instructions and take Resident No. +t follow-up 25 : with his doctor within two days of his discharge from St. Mary's Medical Center. 26} aH a administrator decert and ioanse revo.doe 3©. On various occasions between September 13, 2012 until October 2 2, 2012, Respondent failed to notity Resident No. 1's physician of Resident No. 3 1's unusual weight gain. 4 ‘As a factor in aggravation, on or about September 12, 2012, 5 Angela Lamotto, MD, specifealy dered tha the doctor be notified i Resident 6 No. 1's weight increased by two pounds 7 ‘As an additional factor in aggravation, letersdatod September 8 12, 2012, September 17, 2012, and September 18, 2012, trom Talbert Medical 9 ‘Sroup spectically ordered thatthe doctor be notified if Resident No. 1's weight 10 increased, n ‘As a further factor in aggravation, betwoen September 19, 2012, 2 land October 6, 2012, Respondent documented Resident No. 1's weight » fluctuating up to 1 pounds. u 12. From approximately September 8, 2012, unt October 6, 2012, 15 || Respondents retained Resident No.1, an incividual with a restricted nealth condition, 16 | withoutfolowing regulations as follows: v ‘A. Respondents flied to ensure that wound care was provided to Resident No. 1 by or under an appropriately skied professional 1s | 8. Respondent aed to maintain ongoing conmurisaton wth the 20 | home health agency regarding the services provided to Resident No. 1. a Respondents fies to notify the home heath agency about 22 ragultory requirements fr restricted health condtons 23 18, On orabout October 8, 2012, Respondent Broakers fled 1 contact 911 24 ||for at least 15 minutes despite the imminent threat to Resident No, 1's health, 25 14, From approximately from January 11, 2013, until January 3, 201 26 || Respondents failed to provide basic care to meet the condition and needs of 27 ||Resident No. 2, as follows: |ecminsruorcecer and canserevococ 410 a 32 43 4 45 16 v 18 rr 20 a 22 a 2 25 26 27 ‘A. Respondent Breakers failed to ensure Resident No. 2 obtaln immediate medical attention and an evaluation to determine it Resident No. 2 sustained any internal injuries after Resident No. 2's March 2, 2013, two falls at the facility. B. Respondent Breakers lod to obtain X: vs and an evaluetion| to determine it Resident No.2 sustained any internal injuries were sustained following Resident No. 2's March 3, 2013, falls atthe facilt. 15. Respondent Breakers fallod to provide basic care to meet the condition and needs of Resident No. 7, as follows: A. Respondent Breakers failed to ensure Resident No. 7 received proper dental care resulting in the loss of one tooth due to severe bone loss and the extraction of four teeth. B. Respondent Breakers failed to ensure Resident No. 7 received proper incontinence care resulting in Resident No. 7 suffering from ‘multiple urinary tract infections. ©. Respondent Breakers failed to ensure Resident No, 7's Lifeline ‘was plugged in at all times. SUBJECT MATTER: REPORTING REQUIREMENTS/APPRAISALS/ADMISSION RECORDS/RESIDENT RECORDS APPLICABLE LAW: Health and Safety Code sections 1869.38, 1569.50(a)-(b), 1569,882 and 1569.84 Regulation sections 8721 1, 87483(a), 87465, 67506, 87507, and 87608 ALLEGATIONS: 16, From approximately March 7, 2014 until April 7, 2014, Respondents falled to provide written notice to residents of the facility, their responsible a udminstrator doce and license rvo.dos 514 15 16 W 18 19 20 22 23] 24 25 26 27 parties, and the local ombudsman of the March 7, 2014, Accusation that was filed in this instant matter. 17. From approximately March 7, 2014 until April 7, 2014, Respondents {alled to post a copy of the Accusation in a conspicuous location in the facility. 18. On occasions betwoen January 11, 2013, and January 3, 2014, the exact dates and number of occasions which are unknown to the Department, Respondents failed to report to the Department injuries suffered by Resident No. 2 while under Respondents’ care. 19. Respondents of Resident No. 2 priorto her January 11, 2013, admission to the facility. 1d to complete an accurate preadmission appraisi 20. Between January 11, 2013, and March 20, 2013, Respondents failed to conduct a reappraisal of Resident No. 2 despite having fallen on atleast 4 occasions. 21, Between March 22, 2013 and January 3, 2014, Respondents failed to jconduct a reappraisal ct Resident No. 2 despite having sustained bruises and. skin tears at various times and occasions. i 22, Between August 1, 2009 and May 10, 2018, Resident No. s haa not boon reappraised, 28, Betweon June 1, 2006, and May 10, 2019, Resident No.4, had not been reappraises. | 24, From approximately January 28,2012, unt May 10, 2019, Resident No i did not have @ completed consent form, pre-appraisal or reappraisal. 25. From approximately June 2003 until January 22, 2013, Respondent No. 7 had not been reappraised, " a 1 nominator cecert and conse revo.doe 610 aa 2 a3 4 15 16 vv 18 19 20 a 22 23 24 26 27 26. Respondents failed to complete an individual written admission ‘agreement specifying the services that would be provided to Resident No, 1. ‘As a factor in aggravation, Resident No. 1's authorized representative understood that extra charges were being paid to the faciliy so that the faclity would provide Residert No. 1 with wound care. i 27. Between September 7, 2012, to October 8, 2012, Respondent failed to ‘maintain complete records for Resident No. 1, as foliows: ‘A. Respondent failed to conduct a reappraisal to document Resident No. 1's physical changes. B. Respondents failed to maintain a waitten agreement delinaating the responsitilties of the Healthview Home Health and those of Respondent Breakorsin addressing Resident No. 1's medical condition, I 6. Respondents failed to maintain a continuing record of Resident No. 1's wound. SUBJECTMATTER: OPERATION OF A FACILITY APPLICABLE LAW: Health and Safety Code sections 1569.2 and 1569.616(h) Regulation sections 87208 and 87303, ALLEGATIONS, 28, Between 2011 and August 2013, Respondents failed to comply with |the protocols contained in their Plan of Operation. 29. On various occasions between March 2011 and August 1, 2014, Respondents feiled to maintain the facility in a clean, safe, sanitary and good repair, having roaches and mice in the facility. 90. On various occasions prior to January 2013, Respondents failed to Jensure that the shower seat for Resident No. 7 was in good and safe repair. at a sudminstrator docert and Hosnse rovo doe 71 ||SUBJECT MATTER: ADMINISTRATOR QUALIFICATIONS 2 |/APPLICABLE LAW: Health and Safety Code sections 1569.2 and 1569.616(H) 3 Regulation sections 87101(a)(1), 87405(4)(2) and (5); 4 87408(a) s [ALLEGaTIONS: ° 1. Respendent Cooper was unaware that trom approximately October 7 |/15, 2012 untit October 30, 2012, Linwood Brooks would stay overnight atthe & | tectty with Restent No. 8 9 32. By vitue ofthe facts aleged in paragraphs 11 through 31, Respondent 10 || Cooper has demonstiateda lack of knowedge of and ably to conform othe 11 | apptcabie laws, rulesand reguatons andlor Respondent Cooper has fled to 12 || demonstrate good character and @ continuing reputation of personal integtty as 23 | required of an administrator. 4 (CAUSE FOR DISCIPLINE AND REVOCATION OR FORFEITURE OF 1s ADMINISTRATOR CERTIFICATE 16 93, The facts alleged in paragraphs 11 through 30, individually and/or jointly, 17 || constitute violations o' licensing laws. ‘These facts provide cause, pursuant to Health 18 ||and Safety Code secton 1569.50(a)-(b) to revoke Respondent Breakers’ license to 19 || operate the facity. 20 ‘34. The facts alleged in paragraphs 11 through 30, individually andlor jointly, 21 || constitute conduct by Respondent Breakers whichis inimical to the health, morals, 22 || welfare, or safety of either an individual in of receiving services from the facility or the || people of the State of California, These facts provide cause, pursuant to Health and 24 || Safety Code section 1569.50(¢), to revoke the icense to operate the facity. 38. The facts alleged in paragraphs 11 through 31, individually andlor jointly, 26 || also constitute cause, pursuant to Health and Safety Code sections 1869.616(h)(1) and 27 |i asministratr aecert anc ieonse revedeo 82 | @), and Regulation sections 87405(4), 87408(a) and 87409(a)(1), to revoke 2 || Respondent Cooper's administrator certificate. a PETITION FOR RELIEF 4 36, WHEREFORE, Complainant requests that Respondent The Breakers of 5 | Long Beach's license to operate a resident care Fact forthe elery be revoked. . 37. WHEREFORE, Complainant requests that Respondent Dan Cooper’ 7 || administrator certificate be revoked. e DATED: January 15, 2015 ao Ca biceross —8¢——— Deputy Director a Gommunity Care Licensing Division California Department of Social Services a2 a as » af! a 20 |] a 2a 26 2s 26 ar administrator decer and loense reve doe 8