Routine inspection·January 17, 2024

On 1/17/2024 at 1:40PM, Licensing Program Analyst (LPA) G. Luk arrived unannounced to conduct a Required - 1 Year inspection. LPA met with caregiver, Violeta Butardo and explained the purpose of the visit. Administrator, Joycelyn Castro Silla arrived a hour later. The facility’s fire clearance was approved for 6 non-ambulatory residents of which 2 residents maybe under hospice care. LPA toured the facility including but not limited to bedrooms, bathrooms, dining area, kitchen, garage, and outdoor area. Smoke and carbon monoxide detectors were observed. Fire extinguisher was observed to be full and last serviced on 12/18/2023. One week of nonperishable and 2-day of perishable food supplies were available. Hot water temperature was measured at 108.3 degrees F in the hallway bathroom. LPA observed grab bars and non-skid mat in the bathrooms. There were adequate lights in each room. Resident rooms were observed to be cleaned and fully furnished. First Aid kit is complete. LPA reviewed 4 residents and 2 staff files starting at 2:35PM. LPA reviewed a sample of resident's medications starting at 4:30PM. LPA interviewed 2 residents and 2 staff at 5:20PM. At 2:50PM, LPA observed R1, R2, and R3 does not have current medical assessment on file. At 3:00PM, LPA observed R1, R2, R3, and R4 does not have current needs and service plan on file. At 3:10PM, LPA observed R2 does not have TB test result on file. At 3:30PM, LPA observed S2 does not have current first aid training. At 3:50PM, LPA observed S2 does not have current annual training. (Continue on LIC809C...) At 4:10PM, LPA observed facility have not completed a disaster drill at least quarterly for each shift. At 5:40PM, LPA observed R1's medication (Levothyroxine 25mcg) was given 1.5 tablets according to R1's MAR. However, doctor's order states that medication (Levothyroxine 25mcg) should be given 2 tablets. R1 has doctor's order for Warfarin 2.5mg or 5mg for week of 1/3/2024 and 1/11/2024. However, LPA observed staff gave the incorrect dosage on 5 of those days. The deficiencies were observed (see LIC 809D) and cited from the California Code of Regulations, Title 22 and Health & Safety Code. Failure to correct deficiencies may result in civil penalties. Exit interview conducted. A copy of this report and appeal rights was provided.