Routine inspection·March 29, 2023

On 3/29/23, Licensing Program Analyst (LPA) M. Yang arrived unannounced to conduct an Annual Inspection. LPA arrived and met with Staff Milijaida Roper. LPA introduced self, stated the purpose of the visit, and requested to meet with Administrator. Administrator Susan Kendakur was called and arrived shortly. LPA toured facility with Administrator. All six residents were present during inspection. The tour started in the kitchen into the common areas to resident's rooms. LPA observed COVID-19 related signs. The facility was observed to be at a comfortable temperature, clean, in good repair, and no passageway obstructions or fire hazards were observed inside or outside. Medications are kept locked medication kitchen shelves. At approximately 01:05 PM, LPA and Administrator observed multiple small roaches in resident’s medication tray and in medication shelf. An adequate supply of perishable and non-perishable food was observed. Refrigerator temperature maintained at 40 degrees F. First aid kit was observed and contained all required items. Fire extinguisher was observed with a service date of: 06/01/23. Last fire drill completed on 01/14/23. Residents' bedrooms were toured and observed to be adequately furnished with bed, dresser, and adequate lighting. LPA observed 1 shared residents’ bed to be at least 6 feet apart and 4 single occupant room. Bathrooms were properly equipped, and the hot water temperature was tested 116.7 degrees F in shared bathroom and 117.1 degrees F in hall bathroom. Trash can with lid and hand washing postings was observed. Cleaning supplies and chemicals are kept in locked in garage cabinet. Outside of facility toured. Side gate was self-closing and self-latching. All clients’ file reviewed to have update Emergency contacts, Admission agreement, Pre-Appraisal form, and physician report. A sample of staff's files were also reviewed to have current First Aid/CPR, fingerprinted clear and associated to the facility. Carbon monoxide and smoke detectors were tested and observed to be operational. A deficiency is being cited on the attached 809D in accordance to California Code of Regulations, Title 22, Division 6. Exit Interview conducted. The following documents are requested and submitted to Fresno CCL by: 4/4/23. The following updated forms were requested: Lic 308, Lic 400, Lic 402, Lic 500, Lic 9282, control of property, and current Administrator certificate. A copy of this report was provided to the Administrator.