Routine inspection·May 29, 2024

Licensing Program Analyst (LPA) Katie Brown arrived unannounced to conduct the Annual Inspection. LPA met with and explained the reason for the visit with Administrator Harold Dano. During this visit, LPA toured the facility inside & out Resident rooms are found to be in good repair and contained required furnishings and lighting. The resident bathroom was clean and in good repair with faucets delivering hot water at 109 degrees, grab bars and non-skid mats were in place. LPA observed required hygiene items, towels, extra bedding, and linens were stored and available for use. The kitchen was clean, with necessary items and appliances knives and sharps are locked and stored separate from food. Medications are locked and centrally stored in the kitchen cabinet. The First aid kits contained required items. There are visitation areas available inside and out. Doors and passageways are unobstructed throughout the facility. There are 2 storage sheds on property. LPA observed old beds and furnishings. AD intends to remove these from the yard. The Fire extinguishers were purchased on 4/23/24. Smoke and Carbon Monoxide detectors were tested and found to be in working condition. LPA conducted staff and resident file reviews including medication audit. Emergency Disaster Plan and Infection Control Plans were reviewed during this visit. Deficiencies are being cited in accordance with California Code of Regulations on the attached LIC 809-D in the areas of: Incidental Medical and Dental Care Services, Care of Persons with Dementia An exit interview was conducted and Plan of Correction (POC) developed. A copy of this report was signed by AD and Appeal Rights were provided. LPA requested the following updated forms faxed to CCLD by 6/11//2024: Designation of Facility Responsibility (Lic308), Administrative Organization (Lic309), Surety Bond (Lic402) , Emergency Disaster Plan (LIC610E (2019), Client Roster (LIC 9020), Proof of current Liability Coverage.