Routine inspection·June 12, 2023

On 06/12/2023, Licensing Program Analyst (LPA) Walton arrvied unannounced to conduct an annual inspection. LPA introduced self, stated the purpose of the visit and requested to meet with the Administrator. LPA met with Administrator, Diana Ellis. Administrator has a previously scheduled appointment. LPA received verbal permission to meet with Facility Staff Bobbie Arnold 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 115.3 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 12/12/2022. Smoke detectors and carbon monoxide detectors observed operational during today’s inspection. Last fire drill conducted 05/2023. All cleaning supplies are locked in a secured cabinet in the laundry room. LPA reviewed staff and client records. Resident and staff records observed to missing documents. LPA observed an appraisal / Care Plan for 2 out of 6 residents in care. Medications reviewed and observed to have original labels and be administered as prescribed. A deficiency is being cited in accordance to California Code of Regulations, Title 22, Division 6 on the attached 809D. CONTINUED TO 809C. LPA is requesting the following documents be submitted to the Fresno CCL office by 06/26/2023: · 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 Exit interview conducted. A plan of correction was reviewed and developed with facility staff. A copy of this report and appeal rights were discussed and provided to Facility Staff, Bobbie Arnold, whose signature on this form confirms receipt of this document. 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