Routine inspection·October 3, 2024

Licensing Program Analyst (LPA) Daiquiri Boyd arrived at the facility unannounced to conduct a required annual visit. LPA was granted entry by caregiver staff and explain the purpose of the visit. Administrator Jill Stowell (AD1) was called to come to the home, but she was in Merced and caregivers stated that she would be here in approximately an hour. LPA notified staff that I was going to proceed with the inspection while waiting. At 11:00 AM, LPA asked for arrival time of AD1 and was told she will not be able to make it. Administrator Nancy Wade phoned facility and stated that she would be able to come by in 20 minutes. The residence was set at 78 degrees F temperature and free of passageway obstructions inside and outside. LPAs observed six bedrooms in the residence. Residents' rooms were toured and inspected. Rooms were found to be clean, and furnishing was in good condition. Hot water temperature was measured at 106 degrees F. Bathrooms were clean, in two of the resident bathroom, there was no hand soap available. Kitchen toured, supply of perishable and non-perishable food observed and food was stored properly. There was not enough fresh food present in proper food groups, to accommodate five residents for two days. Medication and knives are locked next to the kitchen area. Medication was properly logged. Medication was being crushed when given to the residents, which LPA did not find any doctors orders stating that this was allowed, in the five resident doctors orders. Cleaning supplies were locked under kitchen sink. Smoke detectors and carbon monoxide were checked and operating. Fire extinguishers were charged and was serviced on 04/04/24. Last fire drill completed on 2/2/23. There was outdoor seating for the residents. Outdoor area was clean and free of obstruction. Two gates exiting the backyard area were observed, the west gate gets stuck on the cement and is difficult to open and the east gate will not open at all. Administrator will fix gates within two weeks. During the visit a file review was conducted for residents and staff files. When reviewing staff files, it was found that there were documents missing. (continued on next page) Resident files were found to not have the most recent documentation available from doctor visits. Administrator was offered TSP services and they were accepted. LPA to refer Rendercare and notify Licensee. An exit interview was conducted, and a copy of this report was provided to Administrator along with appeal rights. Deficiencies were cited on this date. LPA requested the following updated forms faxed to CCLD by 10/17/24: Designation of Facility Responsibility (LIC308), Administrative Organization (LIC309), Personnel Report (LIC 500), Proof of current Liability Coverage.