Routine inspection·May 30, 2023

On 5/30/2023, Licensing Program Analyst (LPA) K. Kaur arrived unannounced at the above facility to conduct an Annual Inspection. LPA introduced self, stated the purpose of the visit, and was granted entry to the facility by staff Isagani Colocado. A tour of the facility was conducted with Administrator Phoeun Marez. Facility appeared cleaned with no obstruction or fire clearance issues. Fire extinguisher in kitchen was last serviced on 3/16/2023 and was fully charged. Hand sanitizer was readily available to residents and visitors. Bathrooms were properly equipped with non-slip mats and grab bars. LPA toured bedrooms with adequate furnishings and lighting. Adequate supply of linens observed in the hallway closet. Cleaning supplies and chemicals are kept locked in garage. LPA checked residents’ medications and observed a 2-week supply which is kept locked in cabinet in the kitchen. At 1:32 LPA reviewed resident’s medication against Centrally stored list and MARs and observed the pill count to be incorrect for one resident. Laundry area observed locked. LPA observed a 7-day supply of non-perishable foods and a 2-day supply of perishable foods. LPA observed sufficient seating under covered patio area in the back of the facility. At 2:10 PM LPA observed one resident Admission Agreement to be missing a resident/power of attorney signature. Resident's records contained Personal Rights, and current Physician's Report. Resident’s files have updated emergency contact information. Staff files were reviewed for good health. It was verified that there are at least two staff on duty who is CPR certified. Deficiency is being cited on the attached 809D in accordance to California Code of Regulations, Title 22, Division 6. Continued on LIC809C ... LPA is requesting the following documents be submitted to the Fresno CCL office by 6/28/2022: Current copy of Administrator Certificate, Designation of Facility Responsibility (LIC308), Administrator Organization (LIC309), Affidavit regarding Client/Resident Cash Resources (LIC 400), Emergency and Disaster Plan (LIC610E), Personnel Report (LIC500), Register of Facility Clients/Residents for LIC9020. An exit interview was conducted with Administrator. Report signed on-site and printed copy provided with appeal rights.