Routine inspection·May 5, 2023

On this day, May 5, 2023, at 11:00 a.m, Licensing Program Analyst (LPA) Delmundo arrived unannounced to conduct an annual required inspection. LPA was granted entry by staff, Jimmy Tolentino. LPA met with Jonabelle Tolentino, administrator, and other staff, Wendy Wong and Olive Manalastas. Facility has an approved LIC808 Mitigation Plan, and on facility file, an LIC9282 Infection Control Plan; LPA inspected the facility inside and out including but not limited to common areas, bedrooms, bathrooms, shower room, living/activity room, kitchen, dining area, front, side and backyard. Facility has sufficient perishable and non-perishable foods. Fire extinguishers were observed fully charge with tags showed serviced February 23, 2023. Facility has smoke and carbon monoxide detectors that were tested and observed functional. Hot water temperature in one of the ensuite toiet was tested, and measured at 105.4 degrees Fahrenheit. Facility conducts disaster drills every 3 months, and records showed last conducted March 1, 2023. LPA reviewed 5 residents and 5 staff files, and interviewed 3 staff and 3 residents. Medications were checked and compared with records. Facility does not handle residents' cash resources. LPA observed the following: -at 11:13 am, a protruding pipe about 8 1/2 inches high from the ground in the front yard. -at 11:40 am, staff's medication in unlocked cabinet in unlocked kitchen. -at 12:00 noon, latch in sliding door in resident's room leading to the front yard, and administrator stated the resident has behavior of opening the door. The door has no auditory alarm. .......continued on 809C -at 12:34 pm and 12:40 pm, shaving cream, and Lysol & Glade spray in the ensuite toilets in residents rooms. --at 1:00 pm, all sliding doors in resident rooms leading to the yard have no auditory signal/alarm. LPA received the following updated documents on this same day: 1. LIC308 Designation of Facility Responsibility 2. LIC500 Personnel Report 3. LIC610D Emergency Disaster Plan (9 pages) 4. LIC9282 Infection Control Plan 4. Proof of $3M liability insurance coverage 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 administrator. Exit interview conducted. Appeal Rights, LIC9098 Proof of Correction form and copy of this report provided.