Routine inspection·November 21, 2023

On 11/21/2023 at 11:10AM, Licensing Program Analyst (LPA) G. Luk arrived unannounced to conduct a Required - 1 Year inspection. LPA met with Administrator, Janice Gombio and Campus Director, Isabel Poderoso. The facility’s fire clearance was approved for 24 non-ambulatory residents of which 12 residents may be under hospice care. LPA toured the facility including but not limited to bedrooms, bathrooms, dining area, activity rooms, kitchen, common areas, and outdoor area. Freezer’s temperature was registered at -20 degree F while the refrigerator’s temperature was recorded at 36 degrees F. Hot water temperature was measured at 108 degrees F in a resident's bathroom. Grab bars and non-skid mats were observed. There were adequate lights in each room. Centrally stored medications were locked in medication carts located outside the med room. First Aid kit is complete. Smoke detectors were interconnected with sprinkler system. Carbon monoxide detector was observed. Fire extinguishers were observed to be full and last serviced on 1/23/2023. Indoor and outdoor passages were free of obstruction. Last fire drill was conducted on 10/16/2023. LPA reviewed 5 resident and 3 staff files starting at 12:45PM. LPA interviewed 3 residents starting at 11:42AM. LPA reviewed a sample of resident's medications starting at 4:00PM. LPA interviewed 3 staff starting at 4:40PM. At 11:30AM, LPA observed facility does not have one week of non-perishable food supplies available. LPA was informed that non-perishable food supplies are kept at a different location. At 1:15PM, LPA observed R1 does not have current medical assessment and R1-R5 does not have current reappraisal needs and service plans on file. (Continue on LIC809C...) At 1:30PM, LPA observed R3 and R4 does not have TB test or chest x-ray results on file during record review. At 2:00PM, LPA observed S3 does not have current annual training completed. At 4:30PM, LPA observed R2 does not have the following medications at the facility including: Hydrocodone Acetaminophen 325mg, Robitussin Peak Cold DM syrup, and Carbamide Peroxide Solution. LPA observed R2 does not have discontinue orders for the three medications. At 5:10PM, LPA observed on Guardian that S4 was not fingerprint cleared. S4's status on Guardian was "closed - incomplete application". LPA observed that S4 left the facility during visit. Civil penalty of $500 is being assessed. 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. A copy of this report, civil penalty, and appeal rights were provided.