Routine inspection·September 16, 2024

Licensing Program Analyst (LPA) Katie Brown arrived unannounced to conduct the Annual Inspection. LPA met with and explained the reason for the visit with Administrator (AD) Shelly Yarbrough. During this visit, LPA toured the facility inside & out. Resident rooms and common areas were clean, in good repair and contained required furnishings and lighting. LPA observed required items in bathrooms with hot water measuring within required limits. LPA observed hygiene items, towels, extra bedding, and linens which were stored and available for use. The kitchen was observed to be clean, in good repair with necessary items and appliances. LPA observed required food supply and paper products. Knives, cleaning/disinfecting supplies and chemicals were locked are stored separate from food. Doors and passageways are unobstructed throughout the facility including outdoors. Medications are centrally stored and locked. A First aid kit contained required items. Facility has multiple visitation and common areas available. LPA walked the outdoor areas to find the grounds well-kept with walkways and sitting areas. Fire extinguishers were serviced and charged on 10/23/23 by Valley Fire Co. Smoke and carbon monoxide detectors were tested and working properly. LPA conducted resident and staff file reviews, P&I and medication audits. Required postings were observed throughout the facility. Emergency Disaster and Infection Control Plans were reviewed during the inspection. Deficiencies are being cited in accordance with California Code of Regulations on the attached LIC 809-D in the areas of: Postural Supports and Personal Accommodations and Services An exit interview was conducted and Plan of Correction (POC) developed. A signed copy of this report and Appeal Rights were provided. See LIC809C for continuation of this report LPA requested the following updated forms faxed to CCLD by 10/16/24: Designation of Facility Responsibility (Lic308), Administrative Organization (Lic309), Affidavit Regarding Client/Resident Cash Resources (LIC 400), Surety Bond (Lic402), Emergency Disaster Plan LIC610D, Personnel Report (LIC 500), Client Roster (LIC 9020), Proof of current Liability Coverage, Infection Control Plan (6/22).