Routine inspection·April 16, 2024

On 4/16/2024 at 9:45AM, Licensing Program Analyst (LPA) G. Luk arrived unannounced to conduct a Required - 1 Year inspection. LPA met with caregiver, Maria Zavala and explained the purpose of the visit. Administrator, Manali Khatu arrived an hour later. LPA toured the facility including but not limited to bedrooms, bathrooms, dining area, kitchen, and outdoor area. Smoke and carbon monoxide combination 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 5 residents and 3 staff files starting at 11:30AM. LPA interviewed 2 residents and 2 staff. LPA reviewed a sample of resident's medications starting at 4:30PM. At 10:15AM, LPA observed unlocked cleaning supplies under kitchen sink and bathroom sink. Staff locked up all the items during inspection. At 10:30AM, LPA observed medication cabinet was unlocked and unlocked medications in the refrigerator. Staff locked up the medications during inspection. At 11:00AM, LPA measured hot water temperature at 138.5 degrees F in the hallway bathroom. Administrator lowered hot water and LPA re-measured hot water at 120 degrees F. (Continue on LIC809C...) At 11:10AM, LPA observed uncleared staff (S5) at the facility. LPA was informed that S5 is a housekeeper. During visit, LPA observed S5 was sitting in the dining table with residents. S5 left the facility during inspection. At 12:00PM, LPA observed S2 and S3 does not have health screening. S3 does not have TB test results. At 12:20PM, LPA observed two non-ambulatory residents in room 5. However, room 5 was approved for ambulatory resident only. LPA observed room 5 has an exit door that was installed recently. At 12:30PM, LPA observed room 5's window was altered to an exit door. LPA was informed that the alteration occurred in October or November of 2023 and currently waiting for retro-permit. Civil penalties are being assessed for repeat violations and caregiver background check. 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 penalty, and appeal rights were provided.