Routine inspection·March 4, 2022

Licensing Program Analyst (LPA) Tao conducted an unannounced annual inspection visit. LPA met with Administrator, Pamela Parsons, and Licensee, Julie Chirikian. Administrator assisted LPA with the visit. The facility is licensed to serve for a capacity of 200 non- ambulatory residents including 25 bedridden residents, ages 60 and above. The facility has an approved Hospice Waiver on file for twenty three (23) residents. Currently, fourteen (14) residents on Hospice. Facility has an approved Dementia Care Plan in their plan of operation and accept residents with dementia. Facility does not handle residents’ moneys. Annual licensing fee is current. Administrator certificate is current and expires on 07/31/22. During the visit, the infection control domain tool was used, a tour of the facility was conducted, food supply was reviewed, and medications were reviewed. The facility is located in a residential neighborhood, consists of three floors/levels and has 186 resident bedrooms and bathrooms. Resident bedrooms, memory care unit, recreation/activity rooms, beauty shop, storage rooms, employee lounge, library and laundry rooms are located at the lower level. Reception/lounge area, resident bedrooms, dining room, kitchen, multiple offices, recreation/activity rooms and laundry room are located at main level. Upper level consists of resident bedrooms, nurse's office, penthouse, recreation/activity rooms and laundry room. A physical tour was conducted. LPA toured resident rooms in random on each floor in building sections A, B, C, D, E and F. Residents’ rooms were well furnished and in compliance. Bathrooms inspected were clean, operable, with the required grab bars and non-skid materials in the shower. Hot water temperature was in a range of 105.2 - 114.8 degrees Fahrenheit which was within Title 22 Regulation guidelines. Adequate linen and personal hygiene supplies was observed. The resident rooms have a signal systems located in each restroom and facility phones to call the front desk. The signal system was tested in different resident's room on each level and was operable. Staff arrived at residents' rooms to respond the calls in a range of 3 to 5 minutes. (-continued in LIC 809 C-) No firearms on the premises. Facility had central air and heating accommodations in the common areas. Facility maintained a comfortable temperature for residents. Auditory alarm devices to monitor exits were operable at the memory care unit at the lower level. Interior and exterior space was available to permit residents to wander freely and safely. Sufficient supply of perishable and nonperishable foods is observed. Knives, tools, sharp items are inaccessible to residents. Food is stored in covered containers at the appropriate temperatures. No pesticides or poisons are stored in the food areas. The last Fire/Emergency Drill is conducted on 01/11/22. Smoke detectors and carbon monoxide detectors are operable. Fire extinguishers has the last service on 01/12/22, are fully charged and in compliance. The carbon monoxide detectors are operable and in compliance. The front grounds of the facility are well landscaped and have a leveled walkway to the entrance. Outside grounds were toured and pool/spa area with self latching fenced gate is observed. The outdoor activity area has a shaded patio with ample seating. Medications are centrally stored and locked in the nurse's office on the upper level. First aid kit is fully stocked. Mandated documents and signages are posted in common areas. Resident records are stored in a locked cabinet and inaccessible to residents. Toxic substances are inaccessible to residents. Deficiencies were observed and cited per California Code of Regulations, Title 22. An exit interview was conducted. This report is discussed and provided to facility Administrator, whose signature on this form confirm receipt of these documents. A copy of appeal rights was provided.