Routine inspection (multi-day)·May 24, 2024

Licensing Program Analyst (LPA) Valeria Conway arrived at the facility unannounced at 8:27 AM for a Case Management – Annual Continuation inspection. The LPA met with facility staff Florencio Aguilon . Administrator was contacted via phone and arrived at 9:26 AM. LPA explained the reason for the visit. During the Required 1-Year on 01/23/2024, LPAs toured the physical plant areas inside and outside to ensure there are no health and safety hazards and facility compliance of Title 22 Regulations. A brief tour of the physical plant was also conducted during today’s visit. No health and safety concerns were identified during today's tour. Administrator stated that on 03/20/2024 facility was approved for the Assisted Living Waiver (ALW). RECORD REVIEW: During today’s visit, LPA reviewed staff files at approximately 9:52 AM. Staff records were reviewed for documents including, but not limited to staff training, fingerprint clearance, health screening, TB test result, and SOC 341 form. Record review and interview conducted revealed that reliever caregivers used by the facility are missing a health screening form (LIC 503) under Falbrook Assistant Living. Staff #1 (S1) and Staff #2 (S2) provided a LIC503 form with a different facility name showing negative TB test for both S1 and S2. Licensee agreed to have a new LIC503 under Fallbrook Assisted Living. A Technical Violation was issued explaining the importance of having records in order for each hired staff. INFECTION CONTROL/EMERGENCY DISASTER PLANNING/EMERGENCY DRILLS: During today’s visit, the LPA reviewed the facility's emergency disaster plan. Plan was observed to be complete and updated annually, as required. Last emergency drill was conducted on 05/23/2024. Residential Infection Control Plan was reviewed. LPA observed this plan to be complete and updated as of 01/02/2024. Continued on LIC 809C Continued from LIC 809. MEDICATION REVIEW: The medication closet is locked and inaccessible to residents in care. Resident’s medication records are kept confidential and locked. At 11:35 AM LPA reviewed centrally store medication sheet and compared it to medication in hand for four (4) out of four (4) residents. At the time of the visit revealed no discrepancies were note. INTERVIEWS: LPA interviewed two (2) staff members and one (1) resident. They don’t have any concern at the time of the visit. No citations observed during today’s visit. Exit interview conducted. A copy of the report is provided