Routine inspection·July 15, 2024

On 7/15/2024 Licensing Program Analyst (LPA) K.Kaur arrived at facility unannounced to complete an Annual inspection. LPA introduced self, stated the purpose of the visit, and was granted entry to the facility by Direct Care Staff. Designee Administrator Carlo Santos was contacted and arrived a short time later. The facility has 5 residents, of which all were present during the inspection. LPA toured the facility with the staff. Facility postings observed at entry. Tour started at Bedroom # 1. Fire extinguisher did not have a service date. Tour continued down the hallway and observed two staff rooms. Two Bathrooms toured LPA observed grab bars installed by toilet and showers and non-skid mats in place. Three additional resident rooms toured at the end of the hallway. Residents' bedrooms were observed to be adequately furnished with beds, dresser, and adequate lighting. Mattresses and linen were in good condition. The dining room is equipped with a table and chairs, the living room is equipped with adequate sofas and recliners for seating. Extra linen and towels are available in the hallway closet. Knives were locked in the kitchen cabinet. LPA observed a 7-day supply of non-perishable foods and 2-day supply of perishable foods. Medications, first aid kit observed locked in cabinet in kitchen area. Cleaning supplies observed locked in the cabinet next in the laundry cabinets. The laundry area toured and observed with locks on all cabinets. Bedroom # 5 toured next to laundry and garage. Garage observed with locked cabinets for chemicals. Smoke alarm detectors and Carbon monoxide detectors installed and operational. Adequate outside space for rest and recreational. Sufficient seating observed under a covered patio. Backyard gate is self-closing and self-latching. Resident's records contained signed Admission Agreement, Personal Rights, and Physician's Report and ID Documentation. All residents Physician's Report were two to four years old. During Medication review LPA observed Centrally Stored Medication and destruction record (CSMDR) was incomplete. PRN medication that came with resident was not logged in CSMDR. Residents’ response to PRN medication was not noted. Staff files were reviewed for good health. Staff files had health screenings/ TB Clearance. It was verified that current staff on duty are CPR certified. Last Fire Drill conducted on 4/10/2024. Continued to 809C... Deficiencies are being cited on the attached 809D in accordance with California Code of Regulations, Title 22 Division 6. LPA is requesting the following documents be submitted to the Fresno CCL office by 7/22/2024: Current copy of Administrator Certificate, Designation of Facility Responsibility (LIC308), Administrator Organization (LIC 309), Affidavit regarding Client/Resident Cash Resources (LIC 400), Emergency and Disaster Plan, Personnel Report (LIC500), Register of Facility Clients/Residents LIC9020. An exit interview was conducted with Administrator. Report signed on-site; a copy of this report, 809D with appeal rights were provided.