Post-licensing visit·November 15, 2023

On 11/15/23, 10am, Licensing Program Analysts (LPAs) Christina Valero and Arvin Villanueva arrived at this facility to conduct a post-licensing inspection. LPAs met with staff on duty (S1), Shyniel Brown and explained the purpose of the visit. S1 then informed Chukwudi Ikiseh via telephone. Chukwudi is unable to come to the facility during the visit and gave S1 permission to sign this report. During this visit, one staff was on duty with four residents in care. At 10:30am LPAs inspected the physical plant including but not limited to the kitchen, dining room, resident bedrooms; resident bathrooms, laundry room, living area, other common areas, and outside of the facility to ensure compliance with Title 22 regulations. Facility is a single-story home with a fire clearance to serve 6 non-ambulatory elderly residents and hospice approved for two (2). Facility has 4 resident bedrooms, and 2 bathrooms for resident use. Each resident have their own bedroom. LPAs observed both bathrooms to contain grab bars, non-skid flooring, shower chairs, close lid trash containers and hygiene supplies. Resident bedrooms were sanitary, furnished, well-lit and had adequate storage for resident’s belongings. The facility common areas are cleaned and furnished. Facility has a dining area off the kitchen and a formal living room. In the kitchen area, LPAs observed the kitchen to be sanitary and free of clutter. Additionally, the kitchen knives and other sharp objects are kept in a locked drawer. Toxins and cleaning supplies are kept locked. LPAs observed the facility to have adequate food supply with at least 2 days’ worth of perishables and 7 days’ worth of non-perishables. LPAs observed the garage to be free of clutter. The garage also houses additional fridge and additional non-perishable food. Additionally, the garage was observed to have couches. {Con't on 809-C} {Con't from 809} The front yard and the backyard are observed to be free of obstruction and well-maintained. Additionally, the backyard has a covered pool but does not contain water. The backyard is furnished with outdoor furniture for outdoor activities. Water temperature reads 105*F to 120*F in one of the bathrooms and room temperature reads 74*F. Smoke and carbon detectors were in good repair. Fire extinguisher was serviced on 5/19/23. Medication storage area was observed to be locked and inaccessible to residents in care. First aid kit was observed to have adequate supplies and accessible to staff. During this inspection 4 resident files were reviewed for regulatory compliance. Only 1 staffing file were available for review for regulatory compliance during this visit. Evidence of staff training was not available for review during this visit. Additionally, evidence of staff first aid training and certificate was not available for review during this visit. Administrator's files were not available for review to confirm appropriate training were taken. In 2 of the 4 resident files that were reviewed, physician reports needed to be updated. During resident file review, LPAs observed 1 of the 4 residents is bedridden and has a restricted health condition. LPAs completed 2 resident interviews and 1 staff interview. Facility has appropriate internet access available for resident use. During this visit, LPAs did not observe recreational activities being provided to resident. LPAs reviewed facility’s disaster plan to ensure regulatory compliance. During record reviews, evidence of quarterly fire drills were not available for review. LPAs also conducted the inspection using the CARE tool. The facility has an approved infection control plan in place. LPAs requested an updated copy of Liability Insurance, LIC 308 and LIC 500. Per California Code of Regulations, Title 22 and Health and Safety Codes, deficiencies were observed during this visit. Licensee was made aware that an immediate civil penalty of $500 will be assessed during today's visit. Interview was held with the Chukwudi Ikiseh via telephone and a copy of this report and appeal rights were provided.