Routine inspection·January 8, 2025

On 01/08/2025 at 9:30 AM, Licensing Program Analysts (LPAs) P. Manalo and K. Nguyen arrived unannounced to conduct 1-Year Annual Required inspection. LPAs met with Executive Director, Meghian Geul, and explained the purpose of the visit. The facility’s fire clearance was approved for capacity of 128 residents and 77 of those residents may be non-ambulatory. The facility is also approved for hospice waivers of 6. LPAs toured the facility inside and out including but not limited to 4 residents' apartments, bathrooms, multiple activity rooms, kitchen, common area and courtyard. There are no bodies of water observed. LPAs observe lighting in all rooms are adequate for the comfort and safety of the residents. Hallway temperature was maintained at 69 degrees F. The hot water temperature in a sample of residents’ shared bathroom were measured at 109.2, 115.5, 108.2 degrees Fahrenheit. Residents’ bathrooms are equipped with grab bars and non-skid mats/ non-skid shower pan. There is a minimum of one week supply of nonperishable and 2-day of perishable foods. Smoke detectors and carbon monoxide detector were in operating condition during visit. Fire extinguisher was last serviced on 02/08/2024 all around the facility. Emergency disaster drill was last conducted on 12/30/2024. At 01:16 PM, LPAs reviewed 6 residents records. At 11:30 AM, LPAs reviewed 6 staff records and 6 of 6 have current first aid training and associated to the facility. At 3:00 PM, LPAs reviewed two sample of resident’s medications. Continue from LIC 809-C... Continue form LIC809... Updated copies of the following documents were requested for facility file and are to be submitted to CCL by 01/22/2025: LIC 308 Designation of Administrative Responsibility LIC 309 Administrative Organization LIC 500 Personnel Report LIC 610E Emergency Disaster Plan Liability Insurance THE FOLLOWING DEFICIENCIES WERE OBSERVED DURING VISIT: At 10:20 AM, LPAs observed a knife in R2's room. At 10:33 AM, LPAs observed Lysol spray and multiple bottles of dish soap in the R3's bathroom. At 10:37 AM, LPAs observed cleaning supplies such as Lysol spray and The Pink Stuff. At 10:38 AM, LPAs observed prescribed solution in R1's bathroom. At 10:45 AM, LPAs observed that the second floor, third floor, and kitchen did not have a full complete first aid kit. At 3:15 PM, LPAs observed that R2 did not have his PRN medication in the Med Tech room. At 3:20 PM, LPAs observed R2 does not have a doctor's order for a medication that was found on his medication bin that labeled R2's room number. The Facility was cited from the California Code of Regulations, Title 22 and/or Health and Safety Code Failure to correct deficiencies by POC date may result in additional Civil Penalties. Exit interview conducted with Executive Director. Appeal Rights and a copy of this report provided.