Routine inspection·April 20, 2023

On 4/20/2023, Licensing Program Analyst (LPA) K. Kaur arrived unannounced at the above facility to conduct an Annual Inspection. LPA introduced self, stated the purpose of the visit, and was granted entry to the facility by staff. LPA conducted facility tour with Administrator. All pathways, entrances and exits were clear from obstructions. The tour started in the kitchen. LPA observed a 7-day supply of non-perishable foods and a 2-day supply of perishable foods. Tour continued to Residents Rooms. LPA toured several bedrooms which were observed to be furnished with required furniture and adequate lighting. Bathrooms were properly equipped with non-slip mats and grab bars. Fire extinguisher in hallway two was last serviced on 8/16/2022 and was fully charged. Closet full of clean linen supply observed. Cleaning supplies and chemicals are kept locked in hallway closet. Medications are kept in 2 locked Med carts in the staff office. At 2 PM LPA reviewed residents medication with MARS and centrally stored list and observed medication was not disturbed to the resident. Resident's records contained signed Admission Agreement, Personal Rights, and current Physician's Report. Staff files were reviewed for good health. It was verified that there are at least two staff on duty who is CPR certified. LPA observed in the facility front yard sufficient seating and shaded area with trees. Deficiency is being cited on the attached 809D in accordance to California Code of Regulations, Title 22, Division 6. Continued on next page. LPA is requesting the following documents be submitted to the Fresno CCL office by 4/27/2023: Current copy of Administrator Certificate, Designation of Facility Responsibility (LIC308), Administrator Organization (LIC 309), Affidavit regarding Client/Resident Cash Resources (LIC 400), Emergency and Disaster Plan, Personnel Report (LIC500), Register of Facility Clients/Residents LIC9020. An exit interview was conducted with Administrator. Report signed on-site; a copy of this report, 809D with appeal rights was provided. .