Pre-licensing visit·August 31, 2022

On 08/31/22, Licensing Program Analyst (LPA) L. Salazar arrived at the facility for an announced Pre-Licensing inspection. LPA was greeted by Administrator, Laura Dobson and RCFE Liason, Colleen Alvarez and allowed entry into the facility. Administrator holds Certificate #6021070740 with an expiration date of 10/23/22. COVID precautionary measures were taken at the time of entry. LPA toured the facility inside and out. LPA observed the required facility postings to include disaster plan, personal rights, discrimination notice, theft and loss policy, facility sketch identifying the emergency exits, CCLD complaint poster and Long Term Care Ombudsman poster. LPA reviewed a sample resident file and observed required licensing forms to be included. The facility has 6 single occupancy rooms located in the 300 wing of the Hoffmann Hospice Home, which is licensed by CDPH. All 6 rooms are fully furnished according to regulation and are free from odor and debris. Rooms include private bathrooms that are equipped with grab bars, covered trash bins, a supply of soap, paper towels and toilet paper. Shower is equipped with non slip adhesive. Fire clearance is approved for 6 non-ambulatory of which (6) may be bedridden. Water temperature was tested and reads at 108 degrees F. Facility emergency exits were free from obstruction. Common areas were observed to be spacious with adequate seating and lighting available. (Continued on 809-C) (continued from 809) LPA observed a hard wired smoke detector system that signals directly to the fire department in case of emergency. Carbon monoxide detectors were also observed in all rooms to be functional. Emergency lighting is observed throughout the building and flash lights are charged and readily available. A supply of extra linen and towels are stored inside a closet in the rooms. LPA observed a separate locked laundry service room located by the kitchen area and away from bedrooms. Kitchen was toured and observed to be clean, stocked with food, dishes and utensils. Chemicals are stored in locked closet, inaccessible to residents. Knives and sharp items are kept locked and secure in the kitchen. LPA observed a locked Medication room in a cental location in the facility. Medications are located in a separate locked room inside locked medication carts. Administrator reviewed medication procedures with LPA to include storage, administration and destruction procedures. All Facility staff who are administering medications are Registered Nurses (RN) and/or Licensed Vocational Nurses (LVN). A First aid kit was observed and contained all required items. Component III was conducted during today’s pre-licensing visit that included a review of Restricted and Prohibited Health Conditions. LPA has found the facility has met all pre licensing requirements. LPA will submit documentation to the Centralized Applications Bureau (CAB) in Sacramento for final review prior to license being issued.