Routine inspection·December 9, 2021

Licensing Program Analysts (LPAs) Joe Katrdzhyan and Alberto Lopez conducted a site visit for the Required - 1 Year inspection. Upon arriving at the facility, LPAs met with Business Office Manager / Diana Marquez and were later joined by the Assistant Administrator / Danny Vera who assisted with the visit. The facility is licensed to serve for a capacity of 75 residents (41 Ambulatory and 34 Non-Ambulatory only) ages 60 and above. Non-ambulatory to be housed on second floor only. No Bedridden allowed. The facility has an approved Hospice Waiver on file for ten (10) Residents. Brookdale Monrovia does not have an approved Dementia Care Plan in their plan of operation and does not accept or care for residents with dementia. During today's visit, LPAs used the infection control domain to complete the Required - 1 Year inspection. Also, the physical plant was toured, medication and food supplies reviewed. LPA 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. The ground floor consists of a dining room, living room/activity room, laundry room, employee break room and a kitchen. The middle floor consists of resident rooms, an outside patio, library, exercise room, beauty shop, medication room and a laundry room. The upper floor consists of resident rooms and a laundry room. The garage is located on the ground floor. LPA toured a random selection of resident rooms on each floor. Resident rooms were furnished appropriately. Each resident room has their own restroom. The bathrooms were observed to be clean and operational w/grab bars. The resident rooms have signal systems located in each room/restroom and facility phones to call the front desk. The signal system was tested in various locations and is operable. The hot water temperature was tested throughout the facility. The facility has central air and heating accommodations. The kitchen was observed. There was a sufficient amount of perishable and non-perishable food supplies and perishable food was stored in covered containers at the appropriate temperatures. No pesticides or poisons were stored in the food areas. Storage areas for cleaning solutions, toxics, knives, and hazardous items were secured and made inaccessible to Residents. The fire extinguishers were observed to be fully charged and in compliance. The facility has carbon monoxide detectors in each resident room. The front grounds of the facility are well landscaped and have a leveled walkway to the entrance. The outdoor area was enclosed and no large bodies of water were observed. A shaded area with chairs is provided in the outside patio, located on the middle floor. Medications are centrally stored in the locked medication room located on the middle floor. A random selection of medications were reviewed to ensure they are being administered as prescribed and prescription and non-prescription PRN medications have signed and dated written orders from the physician. The first-aid kit is fully stocked w/First-aid Manual. The following deficiencies were observed during today's visit; The hot water temperature in the rooms listed below were not in compliance with Title 22 Regulations: At 11:12am, Room #105 kitchen - measured at 124 degrees F. & bathroom - measured at 122.2 degrees F. At 11:19am, Room #131 kitchen - measured at 124.9 degrees F. & bathroom - measured at 123.1 degrees F. At 11:38am, Room #234 bathroom - measured at 123.1 degrees F. At 11:45am, Room 208 kitchen - measured at 121.2 degrees F. At 11:52am, Room #218 kitchen - measured at 98.5 degrees F., bathroom #1 - measured at 97.2 degrees F. & bathroom #2 - measured at 68.1 degrees F. At 12:04pm, LPAs observed the wooden fence located by the east walk way was in disrepair. The fence had broken pieces and was leaning forward (towards the facility). At 11:07am, LPAs observed the wall near the entrance of room #112 was in disrepair. There was a hole on the corner of the wall. At 11:12am, LPAs observed the kitchen top drawer (next to the sink) located in room #105 was in disrepair and would not open or close properly. The following deficiencies were observed to be in violation of California code of Regulations, Title 22, Division 6 (refer to 809D) An exit interview was conducted and a copy of this report was provided along with the Appeals Rights.