Routine inspection·October 20, 2023

On 10/20/23 Licensing Program Analyst (LPA) Mariana Agban conducted an Annual Required visit and inspection of the facility. Upon arrival, LPA was greeted by staff and explained the reason for the visit. Shortly after, LPA met with Licensee Lani Manzano. A tour of the physical plant was conducted at 10:30AM. Kitchen: The kitchen appeared clean and the appliances and fixtures functional. LPA found a sufficient amount of perishable and non-perishable food at the facility; properly stored. Sharp objects were stored in locked drawers and cabinets. Medications are locked in the kitchen cabinet. Medications observed to be locked and inaccessible to clients. LPA observed fully stocked first aid kit in the kitchen drawer. Laundry Area: located through the kitchen. Appliances observed to be in good repair. Laundry detergents were locked inaccessible to residents. Temperature: Facility maintains a comfortable temperature of 78 degrees Fahrenheit. Surrounding Grounds : Entry/exits were observed to be locked. The outdoor area was clean and free of hazards. There is large deck with a patio table and chairs shaded for residents use in the backyard. Patio furniture observed to be in good repair with adequate seating for the residents. Smoke Alarms and Carbon Monoxide: observed to be functional and The fire extinguisher is located in the laundry room observed to be fully charged. Bathrooms: There were three (3) bathrooms in the facility. One (1) bathroom in hallway which is the main, one (1) in a private room and (1) in the laundry room designated for staff use. All bathrooms were clean, properly supplied and had functional fixtures. Water temperatures were: 114.2 and 118.4 degrees Fahrenheit. Bedrooms: There were five (5) bedrooms in the facility. Four (4) designated for residents' use and one (1) for staff use. All bedrooms were clean, properly furnished and had sufficient lighting. Common Areas : This includes the living room dining areas were appropriately furnished and lighting was adequate. The living room has a television and comfortable furniture. LPA reviewed files for all residents. During file review LPA observed 2 missed medication dose for Resident#1 (R1) on 09/29/23. Licensee stated that R1 refused to take medication on that day. Licensee failed to notify CCLD regarding about the incident. (Continue on 809C) LPA reviewed files for staff regularly scheduled at the facility. Staff files included current first aid and CPR certifications as well as sufficient training documentation. Exit interview conducted. Deficiencies cited, appeal of rights and a copy of this report given.