Routine inspection·August 13, 2025

On this day, August 13, 2025, at 12:40 pm, Licensing Program Analyst (LPA) Delmundo arrived unannounced to conduct an annual required inspection. LPA met with staff, Warlita Romero and Norma Gano. LPA called and spoke over the phone with Justino Balintona, licensee-administrator, and informed the reason for visit. LPA asked, and licensee-administrator authorized Norma Gano to be with LPA during inspection. Licensee-administrator arrived around 1:15 pm. LPA started inspection with Norma Gano and continued with licensee-administrator. LPA inspected the dining room, kitchen, bedrooms, bathrooms, living room, 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 in operating condition. Hot water temperature in the common bathroom was tested, and measured at 111.6 degrees Fahrenheit. Facility conducts drills and record showed last conducted July 12, 2025. Fire extinguisher checked and receipt showed purchased May 20, 2025. LPA reviewed 5 residents and 5 staff files, and interviewed 4 residents. Medications checked, and compared with doctor's orders and LIC622 Centrally Stored Medication and Destruction Records. Facility does not handle residents' cash resources. ...continued on 809C LPA observed the following: -at 12:55 pm, medications in kitchen drawer without lock. -at 1:10 pm, Ca-Rezz incontinent wash, Hydrocortisone cream, lighter in unlocked closet in the hallway. -at 1:15 pm, Ca-Rezz in the common bathroom. -at 1:20 pm, unlocked scissors in the resident's room. -at 1:22 pm, Hydrocortisone cream, Ca-Rezz incontinent wash and shaving cream in another resident's room. -at 1:31 pm, scissors, mallet, hammer, screw drivers, lubricant in a plastic storage container in the backyard. -at 3:00 pm, staff (S2) does not have postural support training for 2024. -at 3:15 pm, staff (S3) who was hired in 2024 has only 16 hours of the total 40 hours required training. -at 3:20 pm, staff (S4) does not have postural support training for 2024. -at 3:32 pm, staff (S5) has not completed the required 40 hours of training within the required first 2 weeks of employment. -at 4:15 pm, resident (R2) has multi Vitamins and Ferrous sulfate administered but these are not included on the medications/supplements listed on LIC602A dated 5/27/25. -at 4:50 pm, resident (R3) has 1 medication on listed in After Visit Summary dated 8/05/25 but facility does not have the medication. -at 5:35 pm, resident's (R4) two prescribed medications filled on 6/18/25 and one filled on 7/18/25 not listed on LIC622 Centrally Stored Medication and Destruction Record. Facility does not have 3 of the prescribed medications. Tylenol (Acetaminophen) order is 325 mg but the one in facility's hand is 500 mg. LPA obtained copies of the following updated/current documents: 1. LIC308 Designation of Facility Responsibility 2. LIC500 Personnel Report 3. LIC610E Emergency Disaster Plan 4. $3M liability insurance certificate .......continued on 809C Deficiencies are cited from Title 22 California Code of Regulations and listed on 809Ds. A $250.00 civil penalty is assessed for repeat violation of section 87309(a) within 12 month period and will continue for $100.00/day if not corrected. Failure to submit proof of corrections for the other deficiencies may result in civil penalties. Deficiencies and plan and proof of corrections were discussed with the licensee-administrator. Exit interview conducted. Appeal Rights, LIC9098 Proof of Correction form, LIC421FC Civil Penalty Assessments, and copy of this report provided.