Routine inspection·August 7, 2024

Licensing Program Analysts (LPAs) Angela Barutyan and Emily Peraldi arrived at the facility unannounced to conduct a required annual visit at 09:47AM. LPAs met with staff and Executive Director (ED) Trevin Willis and explained the reason for the visit. Beginning at 12:48PM, the LPAs, along with the ED toured the physical plant areas inside and outside to ensure there are no health and safety hazards and that facility is in compliance with Title 22 Regulations. The following was observed: COMMON AREAS: Upon entry to the facility, there is a central entry point for check in with staff. There are no obstructions and/or tripping hazards throughout the facility. There are fire extinguishers throughout the facility, which are fully charged and last serviced 04/19/2024. Activities are offered and all activity rooms and common spaces appeared clean and in good repair. Fire alarm and sprinkler systems are tested annually and were last tested on 11/20/2023. KITCHEN: LPAs inspected the kitchen at 01:09PM. The facility has a sufficient supply of 2 (two) days perishable and 7 (seven) days non-perishable food and an emergency water supply. Food was stored at appropriate temperatures. Appropriate hand washing signs were posted throughout the kitchen. Facility has a set menu and offers an alternate menu for residents. Food is prepared based on the resident’s diets. Snacks and beverages are available for residents throughout the day. BEDROOMS : The LPAs observed 10 (ten) random resident bedrooms throughout the facility. All resident rooms were observed to be furnished appropriately with clean linens, appropriate furnishings and sufficient lighting. Report Continued on LIC 809-C BATHROOMS : Restrooms were observed to contain nonskid mats and grab bars by the showers and toilets. LPAs measured water temperatures in 5 (five) resident bathrooms and were between 107.8 and 113.2 degrees Fahrenheit, which is within the required range. OUTDOOR SPACE: The LPAs toured the outside area of the facility and observed appropriate outdoor furniture in the courtyard, with a covered shaded area for residents. Parking is available. Area is maintained clean. RECORD REVIEW: LPAs began record review at 10:10AM. LPAs reviewed 5 (five) staff files for documents including, but not limited to: health screening, TB test, training records, fingerprint clearance, and CPR/First-Aid certification. LPAs observed all 5 (five) staff files to have insufficient training with 3 (three) out of 5 (five) staff files missing 40 hours initial training and 2 (two) out of 5 (five) staff files missing 20 hours annual training. Resident files will be reviewed during annual continuation. INFECTION CONTROL/EMERGENCY DISASTER PLANNING: During today’s visit, the LPAs reviewed the facility's infection control practices and the facility's emergency disaster plan. The facility’s policies and procedures as it pertains to infection control are adequate. Emergency disaster plan is updated annually as required. MEDICATION REVIEW: Will be reviewed during annual continuation. INTERVIEWS: During today's visit, LPAs interviewed 4 (four) staff and 5 (five) residents. Pursuant to Title 22, CA Code of Regulations, the following deficiencies were cited (refer to LIC 809-D). Administrator was informed that failure to correct deficiencies may result in civil penalties. Exit interview conducted, report issued, and appeal rights provided.