Routine inspection·April 25, 2023

On 4/25/2023 at 9:35AM, Licensing Program Analysts (LPA) G. Luk arrived unannounced to conduct a Required - 1 Year inspection. LPA met with caregiver, MaryJane Acosta and explained the purpose of the visit. Administrator, Manali Khatu arrived an hour later. The facility’s fire clearance was approved for 6 non-ambulatory residents, of which 1 resident 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, and outdoor area. Smoke and carbon monoxide detectors were observed. Fire extinguishers were observed to be full. One week supply of nonperishable and 2-day supply of perishable foods were available. LPA observed grab bars and non-skid mat in the bathrooms. There were adequate lights in each room. Resident rooms were observed to be cleaned and fully furnished. First Aid kit is complete. The facility has a written emergency disaster plan. LPA reviewed 4 resident and 2 staff files starting at 10:40AM. LPA interviewed 2 residents and 1 staff. LPA reviewed a sample of resident's medications starting at 2:50PM. At 9:58AM, LPA observed unlocked cleaning supplies under kitchen sink. LPA also observed unlocked bleach in the bathroom and unlocked laundry detergent and gardening tools in the back yard. Staff locked up all the items during inspection. At 10:01AM, LPA observed medication cabinet was unlocked. LPA also observed unlocked medications in the staff room and staff room was unlocked. (Continue on LIC809C...) At 10:09AM, LPA measured hot water temperature at 132 degrees F in the hallway bathroom. Administrator lowered hot water and LPA re-measured hot water at 116.9 degrees F. At 11:00AM, LPA observed residents does not have reappraisal or needs and service plan on file during record review. At 1:21PM, LPA observed residents that has half bed rails does not have doctor's orders. At 1:30PM, LPA observed facility did not have a current disaster drill conducted. Facility have not been documenting disaster drills conducted. At 2:58PM, LPA observed R2's MetFormin 500mg was given 1 tab in the evening as stated on MAR (Medication Administration Record). However, the prescription bottle indicates 2 tabs in the evening. There was no doctor's order for a change in dosage. 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 and appeal rights were provided.