Routine inspection·December 26, 2024

On 12/26/2024, 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 Licensee Balwinder Kaur. Facility tour conducted. LPA toured the facility kitchen. LPA observed 7-day supply of non-perishable foods and a 2-day supply of perishable foods. 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 06/22/2024. The dining area is equipped with a table and chairs, the living room is equipped with adequate sofas and recliners for seating. At 10:45 AM LPA observed the hallway closet to have an odor and observed water around the bathroom floor. At 11:14 AM LPA observed two window screen frames for bent. Medications, first aid kit observed locked in the hallway closet. Residents' bedrooms were observed to be adequately furnished with beds, dresser, and adequate lighting. Mattresses and linen were in good condition. LPA observed grab bars installed by toilet. At 11:48 AM LPA did not observe a non-skid mat or strips in the shower. Smoke alarm detectors installed and operational. At 12:29 PM LPA observed Carbon monoxide detector was not operational LPA toured outside and observed covered area for rest and recreational. Sufficient seating observed under a covered patio. LPA observed unlocked bleach and bug spray in the backyard that Licensee locked immediately. LPA reviewed Resident and staff files and observed admission agreements, ID forms. 2 out of 5 residents did not have Appraisal and needs service plans. At 1:19 PM LPA observed 1 out of 5 residents did not have TB clearance documentation at the facility. LPA observed different administrator documentation than the one on file. LPA emailed Licensee the required documentation to make the change. Fire drill conducted on 8/29/2024. Deficiencies are being issued in accordance to California Code of Regulations, Title 22, Division 6 on the attached 809D. LPA is requesting the following documents be submitted to the Fresno CCL office by 01/02/2025: 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. Exit interview conducted and a Plan of Correction was reviewed and developed with Licensee. A copy of this report was discussed and provided to Licensee, Balwinder Kaur, whose signature on this form confirms receipt of this document.