Routine inspection·July 22, 2023

On 07/22/23, Licensing Program Analyst (LPA) Ernand Dabuet conducted an unannounced annual required visit using the CARE Inspection Tool. LPA met with caregiver Pia Luistro and Reyner Navarro. LPA explained the purpose of today’s visit. Cipriana Ancheta the administrator was unavailable to be present for the visit. The facility is licensed to operate for (6) non-ambulatory elderly adults ages 60 and above. Currently, the facility has (1) hospice resident in care. The facility is approved for (6) hospice resident. The facility is a single-story structure located in a residential neighborhood. It consists of the following: (4) residents' rooms, (2) bathrooms, (1) staff bedroom, a living area, a dining area, a kitchen, an outside seating area, and a garage. LPA toured the physical plant. There were no bodies of water on the premises. All rooms were inspected. Beds and bedding supplies were in operational condition, lighting was provided, and storage for the resident's personal belongings was observed. Bed linens, comforters, and bath towels were available during the visit. Bathrooms were operational with water temperature measured at 109.8 degrees F. A comfortable temperature of 75 degrees F. was maintained in the facility. LPA observed the facility to be furnished at the time of the visit. Storage areas for personal hygiene and sharps objects were stored and not accessible to residents. The kitchen was inspected, and sufficient perishable and non-perishable food was maintained adequately. A fire extinguisher was charged. A review of the Medication Records Administration (MAR) was observed to be maintained. (Evaluation Report continues LIC 809-C) During the visit, LPA observed the facility's infection control practices. LPA observed screening protocols for visitors, staff, and residents, and sanitizing stations in common areas and restrooms. LPA observed the facility has a 30-day supply of Personal Protective Equipment (PPE). All mandated inspection control posters were posted. LPA observed First Aid Kit was maintained. A working landline phone was operational. The facility had operational smoke and carbon monoxide in bedrooms and common areas. An audit of residents #1-#4 (R1-R4) service files and staff #1-#4 (S1-S4) personnel files. The facility has the current administrator's certification on file for Cipriana Ancheta #6010956740 Exp 03/01/24. Deficiencies: Observation of cleaning solution/powder bleach in bathroom #2. Observation of full bed rails for room # 4 Residents #1 and #2 and did not a physicians approval. Observation of a hole in the ceiling inside an upper kitchen cabinet. Observation of Resident's medications in prep cups sitting on top of cabinet accessible to residents in care. No proof of certification of Liability Insurance. According to the California Code of Regulations (Title 22, Division 6, Chapter 8), the following deficiencies has been observed and citation issued (ref. LIC 9099-D). Due to time constraints, interviews were not conducted with resident and staff. An exit interview was conducted with Pia Luistro and a copy of the report was provided. Note: *Citations not cleared by the due date will be a $100 fine assessed for each citation until it is cleared. Civil penalties will continue to accrue until Proof of Corrections (POC) are cleared. *