Routine inspection·November 28, 2022

Licensing Program Analyst (LPA) Ashley Smith arrived at the facility unannounced to conduct a required annual visit at 11:25 a.m. The LPA met with staff and explained the reason for the visit. Facility Designee Tom Stiles arrived shortly thereafter, and the LPA explained the reason for the visit. The 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. KITCHEN : Knives and chemicals were locked inaccessible in the kitchen cabinets. Appliances were in operable condition. The facility had a sufficient supply of perishable and non-perishable food. At 11:45 a.m., the LPA observed alcohol accessible in the refrigerator. The items were disposed of upon observation. BEDROOMS : Bedrooms were furnished appropriately; beds were observed with clean linens and rooms had sufficient lighting. All direct exits were clear, and no obstructions were noted. RESTROOMS : Restrooms were clean and sanitary with grab bars and non-skid surfaces. At 12:15 p.m., water temperature measured at 105.5 F. Restrooms were fully stocked. Hand-washing signs were observed in all restrooms. COMMON SPACES : There was a hallway closet with extra linens and towels. Fireplace in the living room was appropriately screened. Medications and files were locked and inaccessible. Fire extinguisher was fully charged and purchased 11/2022. The backyard had furniture and a covered area for resident use. The side gate was self-latching; no bodies of water noted. The facility does not have a garage on the property. The washer and dryer were in the kitchen. Detergent was locked and inaccessible. FILES: The LPA reviewed resident files at 11:55 a.m. One (1) out of six (6) residents (Resident #1 – R1) required an updated appraisal. There were two (2) residents on hospice at the time of the visit. The facility had an appropriate hospice waiver on file. The LPA reviewed staff files at 12:20 p.m. Staff files were in order at the time of the visit. Contact information was confirmed during today's visit. INFECTION CONTROL: There was a central entry point for screening and temperature checks. The LPA was appropriately screened upon entry into the facility. Staff were wearing appropriate face coverings. Infection Control signs were observed throughout the facility. The facility’s cleaning protocol was sufficient. There was record of staff and resident vaccinations. The LPA discussed changes around testing, visitation and vaccine requirements. The facility's procedures as it pertains to infection control are adequate. Pursuant to Title 22 of the CA Code of Regulations, the following deficiencies were cited (refer to LIC 809-D). Exit interview conducted, today's reports and appeal rights were reviewed and issued.