Routine inspection·December 28, 2023

On 12/28/2023, Licensing Program Analyst (LPA) K.Kaur arrived unannounced to conduct an Annual Inspection. LPA introduced self, stated the purpose of the visit and was allowed entry by staff and requested to meet with the Administrator. Facility staff contacted Administrator, Rosemarie Reimer via telephone. Administrator and Licensee, Balwinder Kaur, arrived a short time later. Facility tour conducted. LPA toured the facility kitchen. 7-day supply of non-perishable foods and a 2-day supply of perishable foods. At 9:10 AM LPA observed cleaning supplies to be accessible in a cabinet under the kitchen sink. Medications checked. Medication observed to be locked and inaccessible to residents in care in the closet. Fire extinguisher observed in kitchen which was last serviced on 01/18/2023. LPA toured outside and observed covered area for rest and recreational. LPA observed a pile of clothing outside the staff bedroom. LPA inquired about the clothing and was informed the facility washer is non-operating. When staff try to use washer, it backs up the water in the bathrooms and toilet and leads to water overflowing. At 10:10 AM LPA continued tour to resident rooms and observed hallway lights to be non-operating. At 10:25 LPA observed bedroom fan and ceiling to have caked on dirt and debris. Debris observed throughout the facility flooring. LPA reviewed Resident and staff files and observed missing admission agreement for one resident. Fire drill conducted on 12/18/2023. Due to time constraints, LPA will return at a later date for an annual continuation. Continued to 809C LPA is requesting the following documents be submitted to the Fresno CCL office by 01/04/2024: 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. Deficiencies are being issued 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 and Licensee. A copy of this report was discussed and provided to Licensee, Balwinder Kaur, whose signature on this form confirms receipt of this document.