Routine inspection·June 16, 2023

On 06/16/2023, Licensing Program Analyst (LPA) Walton arrived at the facility unannounced to conduct an Annual Required Inspection. LPA introduced self, stated the purpose of the visit and was allowed to enter the facility. Facility Staff contacted Administrator, Joycelyn Hopper via telephone. Administrator arrived a short time later. 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. LPA observed an adequate supply of linen. 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 107.1 degrees F. Kitchen toured, appeared clean, LPA observed an adequate supply of food. Exterior tour conducted, all exits open and free of obstructions. Side gate was observed to be self-latching. Fire extinguisher serviced on 09/23/2021. Smoke detectors and carbon monoxide detectors observed operational during today’s inspection. Last fire drill conducted November 2021. All cleaning supplies are locked in secured under kitchen sink. LPA reviewed staff and client records. LPA did not observe documentation for training in the personnel records for 3 out of 3 clients. Upon review of resident records, Administrator was unable to provide bank statements to account for client P&I funds. Medications reviewed and observed to have original labels and be administered as prescribed. Deficiencies are being cited in accordance to California Code of Regulations, Title 22, Division 6 on the attached 809D. Exit interview conducted and a plan of correction was reviewed and developed with Administrator. A copy of this report and appeal rights was discussed and provided to Administrator, Joycelyn Hopper, whose signature on this form confirms receipt of this document. CONTINUED TO 809-C LPA is requesting the following documents be submitted to the Fresno CCL office by 06/30/2023: · LIC 308 Designation of Facility Responsibility · -as applicable: LIC 309 Administrative Organization · -as applicable: LIC 400 Affidavit Regarding Client/Resident Cash Resources · -as applicable: LIC 402 Surety Bond · LIC 500 Personnel Report · LIC 610E Emergency Disaster Plan For Residential Care Facilities For The Elderly · LIC 9020 Register of Facility Clients/Residents · Copy of current Liability Insurance As an operator of a Community Care Licensed facility it is your responsibility to be aware of and in compliance with all regulations, including Chaptered Legislation. Go to www.ccld.ca.gov to stay updated and informed