Routine inspection·September 12, 2023

On 9/12/23 at 2:00 p.m., Licensing Program Analyst (LPA) Greg Clark arrived unannounced to conduct 1-Year Annual Required inspection. LPA met with Administrator, Roseli Manglong and explained the purpose of the visit. The facility’s fire clearance was approved for 10 clients of which 10 may be non-ambulatory. LPA toured facility including but not limited to bedrooms, bathrooms, kitchen, common area and backyard. The facility consists of 7 total bedrooms of which 6 bedrooms are occupied by the residents and 1 bedroom is occupied by staff. All outdoor and indoor passageways are kept free of obstruction. There are no bodies of water observed. A comfortable temperature is maintained at 70 degrees Fahrenheit. LPA observed lighting in all rooms are adequate for the comfort and safety of the residents. The hot water temperature in the residents’ shared bathroom was measured at 107.3 degrees Fahrenheit. Residents’ bathrooms are equipped with grab bars and non-skid mats. There is a minimum of one week supply of non-perishable and 2 day of perishable foods. Centrally stored medication and sharps were locked and inaccessible to residents. Smoke detectors and carbon monoxide detector were in operating condition during visit. Fire extinguisher was last serviced on 8/10/23. Emergency Disaster Plan was last posted on 1/14/23. First aid kit was observed to be complete. Fire drill was last conducted on 6/15/23. At 2:15 p.m., LPA reviewed 5 residents records, the records were complete. At 3:30 p.m., LPA reviewed a sample of resident’s medications. ***Report continues on LIC809C*** ***Report continues from LIC809*** At 3:20 p.m., LPA observed pre-poured medications on the kitchen counter in a plastic cup with a resident’s name on it. LPA was told the meds were the resident's PM meds. At 3:40 p.m. LPA requested to review staff files. LPA was told by the administrator that the files were not at the facility. The following deficiencies were observed (see LIC 809D) and cited from the California Code of Regulations, Title 22 and/or Health and Safety Code Failure to correct deficiencies by POC date may result in Civil Penalties. Updated copies of the following documents were requested for facility file and are to be submitted to CCL by 9/19/23: LIC610E Emergency Disaster Plan Exit interview conducted. Appeal Rights and a copy of this report provided.