Routine inspection·March 15, 2023

On 3/15/2023 at 9:30 AM, Licensing Program Analysts (LPAs) L. Francisco and C. Fowler arrived unannounced to conduct 1-Year Annual Required inspection. LPAs met with Administrator, Meeran Saxena and explained the purpose of the visit. The facility’s fire clearance was approved for five (5) non-ambulatory and one (1) bedridden residents. There are 6 residents and 4 staff present during inspection. LPAs toured facility with Administrator including but not limited to bedrooms, bathrooms, kitchen, common area and backyard. The facility consists of 8 total bedrooms which 6 bedrooms are occupied by the residents and 2 bedrooms are occupied by staff. All outdoor and indoor passageways are kept free of obstruction. There are no bodies of water observed. A comfortable temperature is maintained at 74 degrees Fahrenheit. LPA observed lighting in all rooms are adequate for the comfort and safety of the residents. Residents’ bathrooms are equipped with grab bars and non-skid mats. There is a minimum of one week supply of nonperishable and 2-day of perishable foods. Centrally stored medication and sharps were locked and inaccessible to residents. Smoke detectors and carbon monoxide detector were in operating condition during visit. Fire extinguisher was serviced on 1/9/2022 Emergency Disaster Plan was last posted on 3/15/2023. First aid kit was observed to be complete. At 11:15 AM, LPAs reviewed 3 staff records and 2 of 3 have current first aid training and at least 1 staff have CPR training per shift. At 1:40 PM, LPA reviewed a sample of resident's medications. REPORT CONTINUES 809C THE FOLLOWING DEFICIENCIES WERE OBSERVED DURING VISIT: -at 9:58am, LPAs observed Tylenol stored inside medication cabinet in R2's bedroom -at 10:07am, LPAs observed unlocked clorox, drain cleaner, and oxyclean underneath bathroom sink -at 10:28am, LPA observed R3's sliding screen door is off track and in disrepair. -at 11:50am, LPA observed S1's first aid training expired December of 2020 -at 12:15pm, LPA observed quarterly drill was last completed in 2019. -at 12:25pm, LPA observed residents records are not maintained and available to LPAs. Updated copies of the following documents were requested for facility file and are to be submitted to CCL by 3/31/2023 LIC 308 Designation of Administrative Responsibility LIC 309 Administrative Organization LIC 500 Personnel Report LIC 610E Emergency Disaster Plan Liability Insurance Current Administrator’s Certificate The following deficiencies were observed (see LIC 809D) and cited from the California Code of Regulations, Title 22 and Health and Safety Code Failure to correct deficiencies by POC date may result in additional Civil Penalties. Exit interview conducted. Appeal Rights and a copy of this report provided. LPA will return for annual continuation at a later time.