Routine inspection·May 16, 2024

Licensing Program Analyst (LPA) Sandra Urena arrived at the facility unannounced to conduct a required annual inspection. The LPA was greeted by staff and informed them of the reason for the visit. Administrator Hasmik Nshanyan arrived shortly thereafter. The LPA and the Administrator toured the physical plant areas inside and outside to ensure there are no health and safety hazards and facility is in compliance with Title 22 Regulations. KITCHEN: Knives and cleaning supplies are stored inaccessible. Kitchen appliances were in operable condition. The facility has a sufficient supply of perishable and non-perishable food. The hot water temperature measured within the regulation limit. BEDROOMS: Bedrooms were furnished appropriately with clean linens, appropriate furnishings and sufficient lighting. There are three designated residents’ rooms. Room#1 was approved for one ambulatory resident, room #2 is approved for two non-ambulatory residents and room #3 for one bedridden resident. BATHROOMS: Bathrooms were clean and sanitary and in operating condition with grab bars and non-skid surfaces. The bathrooms were sufficiently stocked with soap and paper towels. COMMON AREAS: At the time of the visit, living room and dining room furniture was observed to be in good condition. The facility maintained a comfortable temperature of 76 degrees. Smoke detector(s) and carbon monoxide detector were tested and operational at the time of the visit. The one (1) fire extinguisher(s) was fully charged and were last purchased on 03/01/2024. The LPA observed required postings throughout the common space. OUTDOOR AREA: The front patio has a covered outdoor area equipped with furniture for residents’ use. No bodies of water noted. The washer and dryer are located in the hallway between rooms #2 and #3. Cleaning supplies and disinfectants are kept in locked in a cabinet located inside the hallway bathroom. RECORDS: Records review began at 12:30 p.m., Residents’ records were reviewed for, but not limited to care plans, medical records, admissions agreement, consent forms. All records were in order. Personnel records were reviewed for, but not limited to health assessments, criminal record clearances, first aid/CPR training, and the appropriate training. All files were in order. MEDICATIONS: Medications review began at 1:45.; medications are centrally stored and locked in a cabinet in the kitchen area; medications labeled and checked for expiration dates. Medications were not properly documented on the centrally stored medications and destruction record. The following errors were observed during the medication review. One medication bottle had more than the quantity stated on the bottle. Pursuant to Title 22, California Code of Regulations (CCR), the following deficiency is cited (refer to LIC 9099-D). INFECTION CONTROL : The facility has an adequate supply of Personal Protection Equipment (PPE) and the facility is able to obtain additional supplies as needed. The facility’s cleaning protocol is sufficient. If needed, the facility has the capacity to designate a single isolation room if the facility has a confirmed case of COVID-19. The LPA reviewed the following documents: - LIC500 Personnel Roster - LIC9020 Resident Roster Deficiencies were cited. Exit interview conducted. A copy of the report was issued.