Routine inspection·August 2, 2023

On this day, August 2, 2023, at 12:00 p.m,, Licensing Program Analyst (LPA) Delmundo arrived unannounced to conduct an annual required inspection. LPA met with staff, Warlita Romero and Margarita Corazon Mariano. LPA called and spoke over the phone with Justino Balintona, licensee-administrator, and informed the reason for visit. LPA asked, and licensee authorized Warlita Romero to be with LPA during inspection. Licensee arrived after about 20 minutes. Facility has Infection Control Plan that was submitted on 8/19/22. LPA toured the facility inside out. LPA inspected the dining room, living room, kitchen, bedrooms, bathrooms, side and backyards. Food supplies were observed good for 2 days of perishables and 7 days of non-perishables. Central storage for medications was locked. Facility has smoke and carbon monoxide detectors that were tested, and observed functional. Hot water temperature in one of the bathrooms was tested, and measured at 106.7 degrees Fahrenheit. Facility conducts drills and record showed last conducted 4/22/23. LPA reviewed 4 staff and 5 residents files, and interviewed 2 staff and 2 residents. Facility does not handle residents' cash resources. Medications checked, and compared with records and doctor's orders. LPA observed the following: -at 12:14 pm, All Purpose cleaning agents, Lysol and Purell surface cleaner, Comet in ensuite bathroom cabinet without proper lock. ...continued on 809C -at 12:17 pm, transition metal plate and wood plank in the transition area between the room and ensuite bathroom detached from the flooring. -at 12:24 pm, Lysol and Glade sprays in the common bathroom. -at 12:27 pm, wound, peritoneal cleansers. skin protectant ointment, Glade spray and Natural Breeze spray in one of the resident bedrooms. -at 2:25 to 2:30 pm, staff (S2, S3 and S4) h as only 2 hours dementia training & no 4 hours postural support/restricted health/hospice training for 2022. -at 4:20 pm, R5 has Melatonin OTC medication but not listed on most current list of doctor's order of medications. LPA received the following updated/current documents on this day: 1. LIC308 Designation of Facility Responsibility 2. LIC500 Personnel Report 3. LIC610E Emergency Disaster Plan (9 pages) 4. $3M Liability Insurance certificate Deficiencies are 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. Deficiencies and plan and proof of corrections were discussed with the licensee. Exit interview conducted. Appeal Rights, LIC9098 Proof of Correction form and copy of this report provided.