Routine inspection·March 26, 2024

On 3/26/2024 at 9:20AM, Licensing Program Analyst (LPA) G. Luk arrived unannounced to conduct a Required - 1 Year inspection. LPA met with Caregiver, Wilson Censon and explained the purpose of the visit. The facility’s fire clearance was approved for 6 non-ambulatory residents of which 1 may be bedridden and 2 residents may be under hospice care. LPA toured the facility including but not limited to bedrooms, bathrooms, dining area, kitchen, garage, and outdoor area. Centrally stored medications were locked in hallway closet. First Aid kit is complete. Smoke and carbon monoxide detectors were observed. Fire extinguisher was observed to be full and last serviced on 1/11/2024. One week supply of nonperishable and 2-day supply of perishable foods were available. Hot water temperature was measured at 109.2 degrees F in the hallway bathroom sink. Grab bars for each shower and toilet were installed. Non-skid mats/material were observed. There were adequate lights in each room. LPA reviewed 4 residents and 3 staff records starting at 10:40AM. LPA conducted interviews with 2 residents and 2 staff during inspection. LPA also reviewed a sample of resident's medications and MAR (Medication Administration Record). At 10:10AM, LPA observed unlocked knives in backyard and kitchen drawer. There was unlocked lighters and tools in kitchen drawers. Cleaning supplies cabinet was unlocked during inspection. Staff locked up the items and cabinet during inspection. At 10:20AM, LPA observed room 4's screen door is in disrepair with large holes present. LPA observed dog feces in the backyard in the grass and pathway areas. At 11:00AM, LPA observed R1, R2, and R3 does not have current needs and service plans on file. (Continue on LIC809C...) At 11:10AM, LPA observed R3 and R4 does not have TB test results on file. At 11:45AM, LPA observed S2 and S3 does not have current first aid training on file. At 12:00PM, LPA observed S2 and S3 does not have initial or current annual training on file. At 12:45PM, LPA observed R1 had doctor's order for Vitamin D 4000 units with one soft gel daily. However, LPA observed R1 has a bottle of Vitamin D3 2000 units and R1's MAR stated 1 soft gel given. At 1:00PM, LPA observed the four resident rooms have baby monitor with audio located near resident's bed and the baby monitor receivers are located in the common area near the dining table. The deficiencies were observed (see LIC 809D) and cited from the California Code of Regulations, Title 22 and Health & Safety Code. Failure to correct the deficiencies may result in civil penalties. Exit interview conducted with Wilson Censon. A copy of this report and appeal rights were provided.