Routine inspection·November 1, 2023

On 11/1/2023 Licensing Program Analyst (LPA) M. Garza arrived to complete an unannounced annual visit. LPA met with Administrator, Phoeun Marez explained reason for visit and was permitted entry into the facility. LPA toured the facility inside and out and completed a health and safety check on residents in care. Residents observed in common areas and in rooms. 4 of 6 residents on hospice at time of visit. Pathways and doors were clear and free from obstruction. Facility was clean and without odor. Common areas were clean, adequately furnished, and adequately lit. Smoke detectors and carbon monoxide detectors were present and operational at time of visit. Fire extinguisher last serviced 7/11/23. Last fire drill on 9/4/23. Resident rooms observed to have the required furnishings and with adequate lighting. LPA observed sufficient covered seating in back yard. During visit the following issues were observed by LPA: Chemicals observed in bathroom #1 under sink, in bathroom #2 on counter tops, in the hallway cabinets, outside storage shed and in water heater closet unlocked and accessible. Medications observed in laundry room cabinet unlocked and accessible to residents. Water temperature measured at 122.2. LPA requested the following documents to be submitted to CCL by 11/8/23: current copy of Administrator’s Certificate, Administrator Organization (LIC 309), Designation of Administrative Responsibility (LIC 308), Emergency Disaster Plan (LIC 610-E), Personnel Report (LIC 500), Register of Facility Clients/Residents (LIC 9020) in order to update the facility file. Deficiencies cited during the inspection. Due to time constraints, LPA will return at a later date for an annual continuation. Exit interview completed with Administrator, Phoeun Marez. A copy of this report and appeal rights given.