Routine inspection·April 28, 2023

On 4/28/2023 at 9:05AM, Licensing Program Analyst (LPA) G. Luk arrived unannounced to conduct a Required - 1 Year inspection. LPA met with Manager, Rachell Paniagua. The facility’s fire clearance was approved for 58 non-ambulatory residents and 10 residents may be under hospice care. LPA toured the facility with Rachell including but not limited to bedrooms, bathrooms, dining area, activity rooms, kitchen, common areas, and outdoor area. Centrally stored medications were locked in the med room. First Aid kit is complete. Smoke detectors were interconnected with sprinkler system. Carbon monoxide detectors were observed. Fire extinguishers were observed to be full. Evacuation chairs were observed in both stairwell on the third floor. The facility has a written emergency disaster plan One week supply of nonperishable and 2-day supply of perishable foods were available. Facility orders food once a week. Freezer’s temperature was registered at -3 degree F while the refrigerator’s temperature was recorded at 40 degrees F. Comfortable temperature was maintained inside the facility. Hot water temperature was measured at 108.6 degrees F in a resident's bathroom and 111.6 degrees F in another resident's bathroom located on different floors 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. LPA reviewed 5 resident records and 5 staff records starting at 12:10PM. LPA conducted interviews with 3 residents and 3 staff during inspection. LPA also reviewed a sample of resident's medications and MAR (Medication Administration Record). (Continue on LIC809C...) At 11:23AM, LPA observed R5's Thiamine Vitamin B1 was ordered 100mg one tab daily. However, LPA observed MAR was administering medication as 100mg 5 tabs daily. Staff obtain new order from R5's doctor which was the same as R5's MAR. At 1:30PM, LPA observed R1 and R3 does not have chest x-ray on file during record review. At 1:45PM, LPA observed R3 does not have a completed needs and service plan on file. At 2:00PM, LPA observed S2 does not have completed health screening on file. At 2:15PM, LPA observed S2 and S3 does not have current first aid training. At 2:30PM, LPA was informed that facility did not conduct a recent disaster drill. The deficiencies were observed (see LIC 809D) and cited from the California Code of Regulations, Title 22. Failure to correct the deficiencies may result in civil penalties. Exit interview conducted with Rachell Paniagua. A copy of this report and appeal rights were provided.