Routine inspection·March 28, 2023

On 3/28/2023 at 9:30AM, Licensing Program Analyst (LPA) G. Luk arrived unannounced to conduct a Required - 1 Year inspection. LPA met with Business Office Manager, Jacqueline Scott. The facility’s fire clearance was approved for 46 residents, 40 may be non-ambulatory, 6 may bedridden, and 20 residents may be under hospice care. LPA toured the facility with Jacqueline including but not limited to bedrooms, bathrooms, dining area, activity rooms, kitchen, common areas, and outdoor area. Centrally stored medications were locked in different carts located in the med room. First Aid kit is complete. The facility has a written emergency disaster plan. Smoke detectors were interconnected with sprinkler system. Carbon monoxide detectors were observed. Fire extinguishers were observed to be full and last serviced on 7/1/2022. Weekly and daily menus were posted in dining areas. Varied activities were conducted for the residents. Facility is a memory care facility with the exit doors equipped with delayed egress. One week supply of nonperishable and 2-day supply of perishable foods were available. Facility orders food twice a week. Freezer’s temperature was registered at -2 degree F while the refrigerator’s temperature was recorded at 38 degrees F. Comfortable temperature was maintained inside the facility. Hot water temperature was measured at 107.8 degrees F in a resident's bathroom and 106.1 degrees F in another resident's bathroom located on a different side of the facility. Grab bars for each toilet and shower were installed. Non-skid mats were observed. There were adequate lights in each room. Resident rooms were observed to be cleaned and fully furnished. Indoor and outdoor passages were free of obstruction. (Continue on LIC809C...) LPA reviewed 5 resident records and 6 staff records starting at 10:55AM. Resident records were complete. LPA conducted interviews with 3 residents during inspection. Staff were fingerprint cleared and associated to the facility. At around 2PM, LPA observed S4 did not have a completed health screening on file. The deficiency was observed (see LIC 809D) and cited from the California Code of Regulations, Title 22. Failure to correct the deficiency may result in civil penalties. LPA will return at a later time to complete the inspection. Exit interview conducted with Jacqueline Scott. A copy of this report and appeal rights were provided.