Routine inspection·November 14, 2024

On 11/14/2024 at 9:50AM, Licensing Program Analyst (LPA) G. Luk arrived unannounced to conduct a Required - 1 Year inspection. LPA met with staff, Honey Yang and informed her the reason for the visit. Administrator, Janice Gombio arrived an hour later. 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 -10 degree F while the refrigerator’s temperature was recorded at 36 degrees F. Hot water temperature was measured at 106.5 degrees F in the hallway bathroom. Grab bars and non-skid mats were observed. There were adequate lights in each 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 1/4/2024. Indoor and outdoor passages were free of obstruction. LPA reviewed 5 residents and 4 staff files starting at 10:55AM. LPA reviewed a sample of resident's medications. LPA interviewed 3 staff during inspection. At 10:30AM, LPA reviewed Guardian system and observed S5 is not fingerprint cleared. At 11:30AM, LPA observed R2 does not have current medical assessment on file. At 11:40AM, LPA observed R5 does not have admission agreement on file. At 1:30PM, LPA observed unlocked cough medication in a resident's room. Staff locked up the medication during inspection. (Continue on LIC809C...) At 2:30PM, LPA observed R3's Docusate Sodium was not given according to doctor's order. R3 had doctor's order for Docusate 250mg daily at bedtime and Docusate 100mg as needed. Both orders were not discontinued. However, LPA observed on R3's MAR that Docusate was a PRN (as needed). Staff stated that R3 have not been taking Docusate daily. At 4:30PM, LPA R4's medical assessment stated that R4 is bedridden. R4 is not currently receiving hospice care. Staff stated that R4 needs assistance with turning and repositioning. Facility does not have a bedridden fire clearance. Civil penalty of $500 is being assessed. Facility was given technical violations and reports will be provided. 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. A copy of this report, civil penalties, and appeal rights were provided.