Routine inspection·December 19, 2024

On 12/19/24 Licensing Program Analyst (LPA) M. Garza arrived unannounced for an annual inspection visit. LPA was met by Direct Care Staff, Elizabeth, explained reason for visit and was permitted entry into the facility. Staff, Mark Fuentes was contacted and arrived a short time later. Administrator, Phoeun Marez was contacted and arrived some time later. LPA completed a health and safety check on residents in care. LPA toured the facility inside and out. Residents observed in common areas and in rooms. There was 2 residents on hospice at the time of the inspection. Pathways and doors were clear and free from obstruction. Facility was 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 . Resident rooms observed to have the required furnishings and with adequate lighting. Linen supplies are kept in linen closets. Chemicals and medications were located in locked closets/rooms. LPA observed sufficient seating under covered patio areas. The following issues were observed during todays visit: Scissors were observed in nook area unlocked and accessible to residents in care. Staff at facility upon arrival did not have CPR/1st Aid. Water temperature measured at 129.7 degrees F. Living room carpet has hole near transition from living room to kitchen. Dog urine in master bathroom. Master bedroom has dirty brief. Carpet in master bedroom doorway was lifted and in need of repair. Flooring in hallway bathroom observed lifting and in need of repair. Bedroom #3 observed with paint in need of touch up near night stand. Inside refrigerator observed with liquid at the bottom in need of cleaning. Inside refrigerator missing racks in freezer. Hole in garage behind door in need of repair. Debris observed behind washer and dryer in need of cleaning. Left side gate is not self-latching. Concrete on patio observed with moss in need of cleaning. CONT... CONT... Refrigerator in garage leaking liquid. Freezer observed with severe frost bite and refrigerator missing shelves in need of replacement/repair. Garage door observed dirty and in need of cleaning. Food observed in pantry was not properly sealed. Expired food was observed in pantry. Food observed in outside refrigerator/freezer was severely frost bitten and in need of defrosting. Facility was not observed with the required 7-day non-perishable food source. Facility has Disaster Plan in place however, areas listed need to be update with accurate information. LPA requested the following documents to be submitted to CCL by 12/27/24: 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. Exit interview completed with Administrator, Phoeun. A copy of this report, deficiencies, TV's and appeal rights were provided.