Routine inspection·June 18, 2024

On 06/18/2024, 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. Facility staff contacted assistant administrator, Margaret Gardea-Benavidas (AA) via telephone. LPA received verbal permission to conduct the visit with Facility Staff, Alexa Bravo. AA arrived at the end of the inspection. LPA conducted a tour inside and outside of facility. Facility observed to be odor free and at a comfortable temperature. Common areas were furnished well with adequate seating and lighting available. LPA observed an ottoman and chair to be in need of repair in the living room. Resident rooms appeared clean and had required furnishings. LPA observed a camera with audio and the door track in need of cleaning in bedroom 5. 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. LPA observed the faucet and light bulb in need of repair in the bathroom between bedroom 3 and 4. Hot water measured between 117.6 - 119.3 degrees F. Kitchen toured, appeared clean, and safe for food preparation. LPA did not observe a 7-day supply of non-perishable. Facility had 2-day supply of perishable food. Exterior tour conducted, all exits open and free of obstructions. Side gate was observed to be self-latching. LPA observed the exit door in the dining area in need of repair. Fire extinguisher serviced on 12/18/2023. Smoke detectors and carbon monoxide detectors observed operational during today’s inspection. Last fire drill conducted on 02/27/2024. All cleaning supplies is locked and inaccessible. LPA observed poster PUB 475 to not be posted per Title 22 regulations. Facility did not have a device with internet access for residents in care LPA reviewed staff and client records. Resident and staff records were observed to be incomplete. S3 did not have a medical assessment on file. AA did not have personnel training records on site, LPA will return to review staff training records. Resident admission agreements were not completed per Title 22 regulation. Facility does not have a planned activity schedule on site. Medications reviewed and observed to have original labels and be administered as prescribed. Medications were found not to be stored as directed. First Aid Kit contained the required supplies. CONTINUED TO 809C Deficiencies are being cited in accordance to California Code of Regulations, Title 22, Division 6 on the attached 809D. Exit interview conducted and plans for correction were reviewed and developed with AA. A copy of this report and appeal rights were discussed and provided to AA, whose signature on this form confirms receipt of this document. LPA is requesting the following documents be submitted to the Fresno CCL office by 07/02/2024: 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)