Routine inspection·June 2, 2023

Licensing Program Analyst(s)(LPA) Mary Flores conducted an unannounced annual visit at the facility using the CARE tool. LPA Flores met with Jacqueline Hernandez Business Manager and explained the reason for the visit. Administrator Anabelle Argenal arrived 45 minutes later. The facility is licensed to serve 206 ambulatory and non-ambulatory (in rooms 101-140, except 110, and rooms 201-267) residents over the age of 60, with a hospice waiver for 10. The facility is a two story building located in a residential area and consist of a commercial kitchen, a lobby sitting room area, a dining room, a living room area, a beauty salon, a coffee parlor, an activity room, and a patio. The second floor has a conference room, a patio and most resident rooms. Facility serves dementia residents. LPA conducted a tour of the facility with Jacqueline Hernandez and observed the following: Facility is clean and in good repair indoors and outdoors. Commercial kitchen was observed clean and walking refrigerator and freezer have sufficient food for at least 2 days of perishables and 7 days of non-perishables. Emergency food supplies were observed in a separate closet. 7 resident bedrooms (#105, 107,118,244,265,209,232), were observed to have sufficient lighting, and the required furniture/bedding supplies. Half bed rails were observed in bedrooms #118 and #232. Water temperature was tested in each resident's bathroom; tested between 110.8 and 119.7 degrees F. which is within the required 105-120 degrees F. Activity room was observed with sufficient activity supplies. Patio is enclosed with sufficient shaded sitting area and water features are enclosed by a fence. Facility has a fire sprinkler system throughout. Fire extinguishers were observed and last checked on 7/7/22. Each emergency exit was tested and are in working condition. Call button system in room #232 was tested and staff responded within less than 5 minutes. Last fire drill was conducted on 3/30/23. (CONTINUED ON LIC 809C) LPA reviewed medication and files for 5 residents and 5 staff files. Resident file review revealed resident #1(R1)'s last physician's report is dated 12/1/21, #2(R2)'s last physician report is dated 4/14/22 and resident #5(R5)'s last physician report is dated 4/20/22. No physician's request for half bed rails for R2 and R5 were observed. Administrator certificate was observed for Anabelle Argenal #6034626740 exp. date: 4/21/23, renewal documentation has been received by the department. A copy of liability insurance was requested. LPA interviewed 4 staff and 4 residents. Deficiencies were noted on LIC 809D per Title 22 Regulations. Exit interview was conducted with Anabelle Argenal Administrator and a copy of this report, LIC 809D, and appeal rights were provided.