Routine inspection·May 23, 2024

Licensing Program Analysts (LPA) Christine Wong conducted the required annual inspection. LPA arrived unannounced and met with caregiver Joel Basilio assisted with the visit. The purpose for the visit was explained. The facility is licensed for residents ages 60 and over. The fire clearance is licensed to serve elderly residents age 60 and above. The fire clearance approved for two (2) ambulatory and four (4) non-ambulatory residents age 60 and above. Approved to accept or retain resident one (1) on hospice. LPA utilized the Compliance and Regulatory Enforcement (CARE) tools for the visit today and observed the following: 1. Infection Control: The facility does not have an infection control plan in place but they continue to practice hand washing and disinfect in the facility. Facility has sufficient PPE supplies. All staff does not have any health screening and TB test result in their personnel file. 2. Operational Requirement: he facility has a dementia care plan to accept or retain residents with dementia. Currently there's one resident is on hospice and no resident is bedridden which is under the fire clearance requirement. The liability insurance was not able to review during the annual inspection. 3. Physical Plant and Environmental Safety: The facility is a single story house and located in a residential neighborhood area, the facility includes: living room, family room, dining room, kitchen, live in staff room, five residents bedrooms, three bathrooms and a detached garage. Bedroom#1 has two beds, two drawers, required beddings and furniture and sufficient lighting and closet space. Bedroom#2 to #5 has one bed, one chair, one drawer, required beddings and sufficient lighting and closet space. All the bathrooms have the required grab bar and non-skid mat. The hot water temperature tested in Bathroom#2 and bathroom were 116.4 and 118.4 which are within the Tittle 22 regulation. The hot water in Bathroom#1 is not operating. All the chemicals are stored and locked under the kitchen sink. All the appliances in the kitchen are working properly. The facility has a telephone on the premises. 4. Staffing: Facility has sufficient staffing to provide care and supervision to residents. The facility has at least one person to have CPR and First Aid Training on duty. All the staff are over 18 years old. 5. Personnel Record-Training: All staff files are locked in a locked box under the staff desk. All the staff are fingerprint cleared and associated with the facility. The administrator file was not in the facility and LPA was not able to review administrator qualification. 6. Resident's Right-Information: The facility has all the posted include resident's personal right and complaint poster..etc and its located on the wall near the entrance. The facility also has internet service device for residents to use. 7. Planned Activity: Facility has sufficient space to accommodate indoor and outdoor activities. There are sufficient supplies and equipment to meet resident's physical capability. 8. Food Service: The facility has two days perishable and seven days non perishable food supply. All the food are stored properly in the facility. No resident in the facility required any modified diet that prescribed by the doctor. 9. Internal Medical and Dental: The resident family usually arrange resident's medical and dental appointments. All the resident's medication are centrally stored and LPA inspected all six residents medication and they all seemed accurate and up-to-dated. All the residents have the 30 days supply of medication. 10. Resident Record-Incident Report: All the client's files are stored at the Medication Cabinet near the entry way. LPA inspected all six residents files. All resident files have the face sheet, pre-appraisal and resident's appraisal in file but LPA observed R1, R2, R3 and R4 do not have the updated needs and service plan/appraisal. R2 does not have the updated physician report and the last one was dated back in 2018, R3 does not have any physician report prior the admission. R3 also does not have the signed admission agreement in file. 11. Disaster Preparedness: The facility does not have an updated Emergency Disaster Plan and last one was updated back in 2010. The facility does not have any documentation for fire/disaster drill. The facility does have two alternative shelter location. 12. Residents with Special Health Needs: Currently the facility has two residents are on home health and one resident is on hospice. All the home health information and hospice record are along in resident's files. The facility has a swimming pool in the backyard and it's fenced and compliance with the state and local building codes. All the sharp knives and utensils are stored and locked in the kitchen drawers. The dementia resident does not have an updated Needs and Service plan in file. Deficiencies cited under California Code of Regulations, Title 22, Division 6, Chapter 8 Exit interview was conducted, Appeals Rights discussed and a copy of the report was given to the caregiver Joel Basilio