Routine inspection·March 13, 2024

On 03/13/2024, Licensing Program Analyst (LPA) Walton arrived unannounced to conduct an annual inspection. LPA introduced self, stated the purpose of the visit and requested to meet with the Administrator. Licensee Paulette Holland arrived shotly after LPA. LPA met with Licensee. LPA conducted a tour inside and outside of facility. Facility observed to be clean, odor free and at a comfortable temperature. Common areas were furnished well with adequate seating and lighting available. Resident rooms appeared clean and had required furnishings. Resident bathrooms were properly equipped with securely fastened grab bars in toilet and tub/shower areas, non-skid mats were observed. Hot water measured at 112.6 degrees F in the shared bedroom and 113.2 degrees F in the hallway bathroom.. Kitchen toured, appeared clean, observed a 7-day supply of non-perishable and 2-day supply of perishable food. Exterior tour conducted, all exits open and free of obstructions. Fire extinguisher serviced on 12/08/2023. Smoke detectors and carbon monoxide detector observed operational during today’s inspection. Last fire drill conducted on 01/31/2024. LPA reviewed staff and client records. Upon review of resident records, LPA found that R2 and R5 did not have an updated physician's report. LPA reviewed medication records and found that the facility administered medication outside the parameters of the prescription instructions for R2. LPA reviewed staff records and found that staff records did not have updated training. CONTINUED TO LIC809-C Deficiencies are being issued in accordance to California Code of Regulations, Title 22, Division 6 on the attached 809D. LPA is requesting the following documents be submitted to the Fresno CCL office by 03/27/2024: Current copy of Administrator Certificate, Designation of Facility Responsibility (LIC308), Administrator Organization (LIC 309), Affidavit regarding Client/Resident Cash Resources (LIC 400), Liability Insurance, Emergency and Disaster Plan (LIC 610E) Personnel Report (LIC500), Register of Facility Clients/Residents for (LIC9020A), Surety Bond. Exit interview conducted and a plan of correction was reviewed and developed. A copy of this report and appeal rights were discussed and provided to Licensee, Paullette Holland, whose signature on this form confirms receipt with this document.