Routine inspection·February 26, 2025

On this day, February 26, 2025, at 12:50 pm, Licensing Program Analyst (LPA) Delmundo arrived unannounced to conduct an annual required inspection. LPA met with staff, Caprisha Twine, and informed the reason for visit. LPA called and spoke over the phone with Elton Brown, administrator (ADM). ADM arrived at around 1:05 pm followed by Ester Ramirez, assistant administrator (AADM). LPA started the inspection with Caprisha Twine and continued with ADM and AADM. LPA inspected the facility inside out. LPA inspected the kitchen, dining area, living room, bedrooms, bathrooms, front and backyards. Food supplies were observed good for 2 days of perishables and 7 days of non-perishables. Central storage for medications was observed locked. Facility has 2 in 1 smoke and carbon monoxide detectors that were tested, and observed functional. Hot water temperature in one of the bathrooms was tested, and measured at 115 degrees Fahrenheit. Facility conducts disaster drills at least every quarter and records showed last conducted 12/03/24. LPA reviewed 4 residents and 4 staff files. Residents medications were checked and compared with doctor's orders and LIC622 Centrally Stored Medication and Destruction Records. Facility does not handle residents' cash resources. LPA observed the following: -at 1:01 pm, rotten lettuce, zucchini with mold, expired bacon bits (expiration: 2022) and parmesan cheese (expiration: 2022). -at 1:10 pm, paint in the backyard. -at 1:18 pm, peritoneal cleanser, Cortizone ointment in a closet without lock. .......continued on 809C -at 3:50 pm, 2 of resident's (R1) medications not recorded on LIC622. Administrator to submit updated/current copies of the following by March 12, 2025: 1. LIC308 Designation of Facility Responsibility 2. LIC500 Personnel Report 3. LIC610E Emergency Disaster Plan (9 pages) 4. Proof of $3M liability insurance 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 penalty. Deficiencies and plan and proof of corrections were discussed with ADM and AADM. Exit interview conducted. Appeal Rights, LIC9098 Proof of Correction form and copy of this report provided.