Routine inspection·August 2, 2023

On 8/2/2023 at 9:30AM, Licensing Program Analyst (LPA) G. Luk arrived unannounced to conduct a Required - 1 Year inspection. LPA met with Administrator, Steve Battisti and Health & Wellness Director, Susan Donaghy. The facility’s fire clearance was approved for 65 non-ambulatory residents and 8 residents may be under hospice care. LPA toured the facility with Susan including but not limited to bedrooms, bathrooms, dining area, activity rooms, kitchen, common areas, and outdoor area. Centrally stored medications were locked in different carts located in the med room. First Aid kit is complete. The facility has a written emergency disaster plan. Smoke detectors were interconnected with sprinkler system. Carbon monoxide detector was observed. Fire extinguishers were observed to be full and last serviced on 2/1/2023. One week supply of nonperishable and 2-day supply of perishable foods were available. Facility orders food supplies twice a week. Freezer’s temperature was registered at -3 degree F while the refrigerator’s temperature was recorded at 38 degrees F. Hot water temperature was measured at 112.3 degrees F in a resident's bathroom sink. Grab bars and non-skid mats were observed. There were adequate lights in each room. Indoor and outdoor passages were free of obstruction. Last fire drill was conducted on 7/20/2023. (Continue on LIC809C...) LPA reviewed 5 resident and 5 staff files starting at 11:45AM. LPA interviewed 4 residents and 4 staff starting at 10:30AM. LPA reviewed a sample of resident's medications starting at 3:45PM. At 12:45PM, LPA observed S3 does not have health screening and TB test completed. At 1:00PM, LPA observed S4 does not have current first aid training completed. At 4:15PM, LPA observed R2 did not have Bengay gel PRN medication available. Record review shows that the gel was in the current MAR. R2 have not used this medication since doctor's order on 6/8/2023. The deficiencies were observed (see LIC 809D) and cited from the California Code of Regulations, Title 22. Failure to correct the deficiencies may result in civil penalties. Exit interview conducted. A copy of this report and appeal rights were provided.