Routine inspection·August 12, 2024

On 08/12/2024, Licensing Program Analyst (LPA) Walton arrived unannounced to conduct an annual inspection. LPA introduced self, stated the purpose of the visit and requested to meet with the Administrator. LPA was granted entry to the facility. Facility staff and LPA attempted to contact Administrator, John Nobleza, via telephone. Administrator did not respond. LPA met with Facility staff Ronaldo Nobleza. 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 a large couch and a wheel chair blocking the exit in bedroom 3. 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 measure at 117.1 degrees F. Kitchen toured, appeared clean, observed a 7-day supply of non-perishable and 2-day supply of perishable food. Exterior tour conducted, all exits open and free of obstructions. Side gate was observed to be self-latching. Fire extinguisher serviced on 07/26/2024. Smoke detectors and carbon monoxide detectors observed operational during today’s inspection. Documentation of last fire drill was not provided during inspection. All cleaning supplies are locked in secured under kitchen sink. LPA reviewed staff and client records. LPA found the R3 did not have a current resident records on file. LPA also found that R3 did not have a complete hospice care plan on records. Medications reviewed and observed to have original labels and be administered as prescribed. LPA observed facility staff administer a glucose test for a resident in care. 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. A copy of this report and appeal rights were discussed and provided to Facility staff, whose signature on this form confirms receipt of this document. LPA is requesting the following documents be submitted to the Fresno CCL office by 08/26/2024 : 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.