Routine inspection·November 19, 2022

Licensing Program Analyst (LPA) V. Maldonado made an unannounced visit to the facility for the purpose of conducting the required annual inspection, using the Infection Control tool to evaluate the facility. LPA Maldonado met with Administrator Carina Demman and explained the purpose for the visit. LPA conducted a tour of the physical plant with Carina, observed the food supplies, COVID-19 procedures, and reviewed client and staff files, and residents' medications. The facility has an approved mitigation plan on file. The facility is a one-story home located in a residential area. It is licensed to serve (6) elderly residents, ages 60 and above, of which all may be non-ambulatory, and is approved to retain (1) resident on hospice. The home consists of a living room, kitchen, dining room, TV room, (8) bedrooms, of which (2) are for staff, (4) bathrooms, of which (2) are for residents and (1) is for visitors, a shaded patio in the backyard with seating, and an attached garage. LPA observed all resident bedrooms to have the required furniture, bedding, linens, sufficient lighting, closet space, and additional storage space. LPA observed room# 2 to have baby powder spread underneath a resident bed and around the room floor, which made the floor slippery. Administrator stated caregivers clean once a week, but had not yet cleaned today. (2) resident bathrooms were observed to have a shower, toilet, and wash basin. The showers accommodate non-ambulatory clients and have the required grab-bars and non-skid mats. The water temperature was tested and measured between 118*F-120*F, which is in compliance. The food supplies was observed to be the required 2-day perishables and 7-day non-perishables. The kitchen stove top had accumulated grease on the grills and burners as well underneath the microwave, which is located right above the stove, which poses a hazard for a grease fire. Fire extinguisher were observed throughout the facility to have current inspections and were fully charged. The first aid kit was inspected and had the required items, as well as a current first aid manual. All sharps were observed to be locked and inaccessible in a kitchen cabinet. Cleaning supplies were locked and inaccessible, stored in a cabinet underneath the kitchen sink. The smoke/carbon monoxide detectors were tested, were interconnected and operational at the time of the visit. (Report continued on LIC809-C...) LPA observed a 30-day supplies of Personal Protective Equipment (PPE) stored in the kitchen and in the garage. Additional PPE was observed at the entrance of the facility- the central entry point for screening clients, staff, and visitors. PPE siganage was observed throughout the facility to promote hand washing, cough/sneeze etiquette, and social distancing. All hand washing stations are fully stocked with soap and paper towels. All client files were reviewed and had updated emergency contact information and health screenings. (3) staff files were reviewed and had Criminal Background Clearances, health screenings, and proof of required annual training and certifications. All client medications were reviewed. They are documented properly and given as prescribed. Per California Code of Regulations, Title 22, and Health and Safety Codes, deficiencies were observed and will be cited in the LIC809-D. An exit interview was conducted with administrator Carina and a copy of this report and appeal rights were provided.