Routine inspection·September 1, 2023

On 9/1/2023 at 9:20AM, Licensing Program Analyst (LPA) G. Luk arrived unannounced to conduct a Required - 1 Year inspection. LPA met with Administrator, Elizabeth Nagy. The facility’s fire clearance was approved for 6 non-ambulatory residents and 2 residents may be under hospice care. LPA was informed the two residents moved out the facility on Monday (8/28/2023) due to repairs that will start this week. Facility had water damage on one wall in the office area and damages to the roof and rain gutters. LPA observed no damages to the resident rooms. 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. One week of nonperishable and 2-day of perishable food supplies were available. Hot water temperature was measured at 105.9 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. The facility has a written emergency disaster plan. LPA reviewed 2 staff files starting at 10:23AM. LPA interviewed 2 staff at 11:20AM. At 10:00AM, LPA was informed there was damages to the facility including roof and wall about 2-3 months ago. However, Administrator did not notify to CCLD and did not submit an incident report. At 10:50AM, LPA observed S2 does not have chest x-ray on file during record review. (Continue on 809C...) At 12:00PM, Administrator was unable to provide disaster drill documents and stated that a drill was conducted about 6 months ago. 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.