Routine inspection·December 7, 2023

On this day, December 7, 2023, Licensing Program Analyst (LPA) Delmundo arrived unannounced to conduct an annual required inspection. LPA met with Fekerte Hyesus, administrator, and informed the reason for visit. LPA also met with other staff, Avelina Sagnep. Administrator submitted the facility's Infection Control Plan which LPA received on November 11, 2022. LPA toured the facility inside out with the administrator. LPA inspected the kitchen, dining area, living room, bedrooms, bathrooms, side yard and backyard. Food supplies were observed good for 2 days of perishables and 7 days of non-perishables. Central storage for medications was observed locked. Facility has smoke and carbon monoxide detectors that were tested, and observed functional. Facility conducts disaster drills quarterly, and records showed last conducted September 15, 2023. Fire extinguishers checked, observed fully charge with tags showed serviced May 25, 2023. LPA reviewed 4 staff and 5 residents files, and interviewed 2 staff and 2 residents. Medications checked, and compared with records and doctor's orders. Facility does not handle residents' cash resources. LPA received the following updated/current documents: 1. LIC500 Personnel Report 2. LIC610E Emergency Disaster Plan (9 pages) .....continued on 809C Administrator to submit copies the following by December 21, 2023: 1. $3M Liability Insurance certificate 2. LIC308 Designation of Facility Responsibility The following deficiencies were observed and cited from Title 22 California Code of Regulations, and listed on 809Ds. Failure to submit proof of corrections by plan of correction due dates, and any repeat violation within 12 month period may result in civil penalties. -at 12:30 pm, knives in kitchen cabinets without lock. -at 12:33 pm, bleach, cleaning agents, and Comet cleanser in the Alarm Panel room without lock -at 2:00 pm, administrator's First Aid certificate expired 11/24/23. -at 2:10 pm and 2:25 pm, S2 and S3 have no LIC503 Health Screening on file. -at 2:35 pm, S4 who got hired 7/2023 has only 21 hours training on file. Deficiencies and plan and proof of corrections were discussed with the administrator. Exit interview conducted. Appeal Rights, LIC9098 Proof of Correction form and copy of this report provided.