Routine inspection·October 25, 2024

On 10/25/2024, Licensing Program Analyst (LPA) Daiquiri Boyd arrived at the facility unannounced to conduct a required annual visit. LPA was granted entry by caregiver staff, J. Paggao. LPA explained the purpose of the visit and staff M. Paggao stated that the Administrator was out of the country and that she would call the other Administrator to come. M. Paggo stated that Administrator Parminder Kaur was working as a Hospice Nurse and she was unable to come right now, but might come later. LPA called Administrator Kaur and was given permission for M. Paggo to assist LPA today and sign and Administrator Kaur is available by phone. The residence was set at 75 degrees F temperature and free of passageway obstructions inside and outside. LPAs observed six bedrooms in the residence. Residents' rooms were toured and inspected. Rooms were found to be clean, and furnishing was in good condition. Hot water temperature was measured at 120 degrees F. Medications were observed locked in a closet off of the kitchen area. Kitchen toured, supply of food observed, and food stored properly for perishable and nonperishable. Medications are locked next to the kitchen. Sharps and knives are locked in the kitchen area. Cleaning supplies were locked under kitchen sink. Smoke detectors and carbon monoxide were checked and operating. Fire extinguisher was new and purchased on 07/10/2024. There was outdoor seating for the residents. Outdoor area was clean and free of obstruction. Backyard gate connecting to the front driveway does not close without force. Emergency and Disaster Plan dated 09/20/2019 was observed on the wall of the facility and needs to be reviewed at least annually, which it has not been. During the visit a file review was conducted for residents and staff files. See LIC811 for confidential names. Refer to 809D for deficiencies issued on this day. An exit interview was conducted, and a copy of this report was provided to caregiver staff, M. Paggao whose signature confirms receipt. LPA requested the following updated forms faxed to CCLD by 11/01/24: Designation of Facility Responsibility (LIC308), Administrative Organization (LIC309), Personnel Report (LIC 500), Proof of current Liability Coverage, and administrator certificate.