Routine inspection·June 12, 2024

On 06/12/24, 10am, Licensing Program Analysts (LPAs) Ariel Pascua and Arvin Villanueva arrived unannounced at this facility to conduct the required annual inspection. LPAs met with staff on duty (S1), and explained the purpose of the visit. S1 informed Chukwudi (Patrick) Ikiseh via telephone. Patrick arrived at 2pm. During this visit, one staff was on duty with 3 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 one bathroom and contain grab bars, non-skid flooring, shower chairs, close lid trash containers and hygiene supplies. During an inspection of one of the bathrooms, LPAs found a drain cleaner under the sink and was observed to be accessible to residents in care. Resident bedrooms were observed to be furnished, well-lit and had adequate storage for resident’s belongings. Facility has a dining area off the kitchen and a formal living room. During an inspection of the kitchen area, LPAs observed the knife/sharp drawer was unlocked and accessible to residents in care. In the kitchen refrigerator, LPAs observed a two containers of Lozenges. Per interview with S1, no one is using these Lozenges and S1 threw them in the garbage. 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 contain additional food supplies. Also in the garage LPAs observed resident medications inside a small refrigerator. The small refrigerator was observed to be unlocked. Also the door to the garage was unlocked during this visit which makes it accessible to residents in care. Additionally, the garage was observed to have 2 futons, a cabinet, a drawer, a desk and chairs. {Con't to 809-C...} The front yard and the backyard were inspected. Facility has a covered pool but does not contain water. The gate to the pool was observed to be locked and not accessible to residents in care. The backyard is furnished with outdoor furniture for outdoor activities. The deck floor was observed to be in disrepair. The rail for the deck was observed to be slightly bent and loose. Water temperature read 110 degrees F in one of the bathrooms and room temperature reads 76 degrees F. Smoke and carbon detectors were in tested and operational. Fire extinguisher was last serviced on 5/19/23. Medication storage area was observed to be locked and inaccessible to residents in care (except for the medications found in the garage). First aid kit was observed to have adequate supplies and accessible to staff. During staff record review, 3 of 5 staff did not have file available for review. The facility administrator, Mama Ngaima does have a current administrator certificate during this visit. Administrator's training requirements were not available for review at this time. During resident record review, 1 of 4 residents does not have an updated Physicians Report. Last Physician Report was last done on 4/22/2019. 2 of 4 residents in care does not have updated Needs and Services Plan. 1 out of 4 residents were diagnosed as bedridden observed on their 602 however was placed in a non-ambulatory room. 4 of 4 residents do not have PRN Authorization letter. Facility has appropriate internet access available for resident use. During this visit, LPAs did not observe recreational activities being provided to resident. During record reviews, evidence of quarterly fire drills were observed. 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 to be email to LPA Villanueva. 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 Patrick Ikiseh and a copy of this report and appeal rights were provided.