Routine inspection·June 20, 2024

On 6/20/2024 at 8:45AM, Licensing Program Analyst (LPA) G. Luk arrived unannounced to conduct a Required - 1 Year inspection. LPA met with Administrator, Aurora Cicai and explained the purpose of the visit. The facility’s fire clearance was approved for 6 non-ambulatory residents. LPA toured the facility including but not limited to bedrooms, bathrooms, dining area, kitchen, basement, and outdoor area. Smoke and carbon monoxide detectors were observed. Fire extinguisher was observed to be full and last serviced on 6/6/2024. One week of nonperishable and 2-day of perishable food supplies were available. Hot water temperature was measured at 119.7 degrees F in the hallway bathroom. 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. Last fire drill was conducted on 4/13/2024. LPA reviewed 2 resident and 3 staff files starting at 9:30AM. LPA interviewed 2 residents and 2 staff. LPA reviewed a sample of resident's medications starting at 10:50AM. At 9:40AM, LPA observed R2 does not have current medical assessment on file. At 10:00AM, LPA observed S3 does not have annual training completed. At 11:00AM, LPA observed facility does not have MAR (Medication Administration Records) for resident's PRN medications. (Continue on LIC809C...) At 11:05AM, LPA observed a bottle of aspirin in R1's medication box. LPA was informed that R1 is given aspirin daily. However, staff was not able to provide doctor's order for R1's aspirin. At 11:40AM, LPA observed facility does not have a telephone land line. LPA tested cordless phone and there was no dial tone. LPA was informed that the telephone land line was disconnected a couple months ago. The deficiencies were observed (see LIC 809D) and cited from the California Code of Regulations, Title 22 and Health & Safety Code. Failure to correct the deficiencies may result in civil penalties. Exit interview conducted. A copy of this report and appeal rights were provided.