Routine inspection·November 10, 2023

On this day, November 10, 2023, at 10:15 am, Licensing Program Analyst (LPA) Delmundo arrived unannounced to conduct an annual inspection. LPA met with staff, Efren Moreno, Sally Espina, Nangtin Lwin. LPA called and spoke over the phone with Haidie Bautista, administrator, and informed the reason for visit. Administrator arrived after several minutes. Facility has LIC9282 Infection Control Plan. LPA started the inspection with Sally Espina and continued with Haidie Bautista. LPA inspected the 2 buildings (Bldg A and Bldg B) including but not limited to common areas, kitchen, dining areas, receiving room, library, staff room, bathrooms, shower rooms, toilets and yard. LPA selected for inspection 3 residents rooms in each in Bldg A and Bldg B. Fire extinguishers were observed fully charge with tags showed serviced March 16. 2023. Food supplies were observed good for 2 days of perishables and 7 days of non-perishables. Central storage for medications and medication carts were locked. All residents rooms, dining and common areas were equipped with electric fans. Hallways, common areas, yards and porch were observed free of hazards. Facility has smoke and carbon monoxide detectors that were observed functional. Hot water temperature in bathrooms in Bldg A and Bldg B was tested and measured at 119 and 120 degrees Fahrenheit. F acility conducts fire drills every quarter and records showed last conducted October 1, 2023. .......continued on 809C LPA reviewed 5 residents and 3 staff files, and interviewed 3 staff and 3 residents. Medications were checked and compared with records. Facility does not handle residents' cash resources. Administrator to submit a copy of updated LIC500 Personnel Report by 11/24/23. 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 penalties. -at 10:43 am, medications in unlocked staff room. -at 12:51 pm, staff S3 has no first aid and 4 hours postural support/restricted health/hospice care training. Deficiencies and plan and proof of corrections were discussed with the administrator. Exit interview conducted. Appeal Rights, LIC9098 Proof of Correction form and copy of this report provided.