Routine inspection·November 2, 2023

On 11/2/2023 at 9:10AM, Licensing Program Analyst (LPA) G. Luk arrived unannounced to conduct a Required - 1 Year inspection. LPA met with caregiver, Olivia Aquino and explained the purpose of the visit. Assistant Administrator, Marjorie Osia arrived 40 minutes later. Administrator, Giselle Adams arrived at facility around 12:30PM. The facility’s fire clearance was approved for 6 non-ambulatory residents. 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 7/14/2023. One week of nonperishable and 2-day of perishable food supplies were available. Hot water temperature was measured at 116.5 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. Last fire drill was conducted on 9/20/2023. LPA reviewed 5 resident and 4 staff files starting at 10:45AM. LPA reviewed a sample of resident's medications starting at 1:50PM. LPA interviewed 2 residents and 2 staff at 2:30PM. At 9:45AM, LPA observed knives drawer was unlocked. LPA observed the lock on the drawer was broken and unable to lock properly. Administrator repaired lock during inspection. At 11:00AM, LPA observed R1 does not have a current appraisal needs and service plan and R4 does not have a current medical assessment on file. At 11:10AM, LPA observed R3 does not have TB test result on file during record review. (Continue on LIC809C...) At 12:00PM, LPA observed S1 does not have a current First Aid training. At 12:30PM, LPA observed S3 does not have current annual training completed. S3's most recent training was completed in April 2022. At 1:00PM, LPA observed R3 and R5 does not have a doctor's order for full bed rails. Both R3 and R5 is on hospice care. At 2:10PM, LPA observed doctor's order (dated 8/2/2019) for R1's Citalopram was 10mg. However, R1 has a open bottle of Citalopram for 20mg. Facility's MAR also has Citalopram 20mg documented. Facility obtained a copy of the new doctor's order during inspection. 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.