Routine inspection·August 29, 2023

On 08/29/2023, Licensing Program Analyst (LPA) Walton arrived at the facility unannounced to conduct an Annual Required Inspection. LPA introduced self, stated the purpose of the visit and was granted entry to the facility. LPA met with Administrator, Honora Gamueda. LPA conducted a tour inside and outside of facility. Facility observed to be clean, odor free and at a comfortable temperature. Common areas were furnished well with adequate seating and lighting available. Resident rooms appeared clean and had required furnishings. LPA observed an adequate supply of linen. Resident bathrooms were properly equipped with securely fastened grab bars in toilet and tub/shower areas, non-skid mats were observed. Hot water measured at 99.5 degrees F in bathroom 1, 99.1 degrees F in bathroom 2, and 97.5 degrees F in bathroom 3. Kitchen toured, appeared clean, observed a 7-day supply of non-perishable and 2-day supply of perishable food. Exterior tour conducted, all exits open and free of obstructions. Side gate was observed to be self-latching. Fire extinguisher serviced on 08/25/2022. Smoke detectors and carbon monoxide detectors observed operational during today’s inspection. Last fire drill conducted on 07/05/2023. All cleaning supplies are locked and inaccessible. LPA reviewed staff and resident records. LPA did not observe a Needs and Services Plan for 5 out of 5 residents in care. Medications reviewed. Record review revealed that R2 has been receiving an over the counter medication that has not been prescribed by a physician. Medication records were incomplete. LPA observed that resident prescription labels were altered and medication had been transferred between containers. First Aid Kit contained the required supplies CONTINUED TO 809C Based on today's inspection, deficiencies were cited in the areas evaluated and listed on the 809-D according to California Code of Regulations, Title 22, Division 6. Exit interview was conducted and a plan of correction was reviewed and developed. A copy of this report and appeal rights were discussed and provided to Administrator, Honora Gamueda, whose signature on this form confirms receipt of this document LPA is requesting the following documents be submitted to the Fresno CCL office by 09/12/2023 : Current copy of Administrator Certificate, Designation of Facility Responsibility (LIC308), Administrator Organization (LIC 309), Affidavit regarding Client/Resident Cash Resources (LIC 400), Liability Insurance, Emergency and Disaster Plan (LIC 610E) Personnel Report (LIC500), Register of Facility Clients/Residents for (LIC9020A), Surety Bond.