Routine inspection·May 22, 2024

Licensing Program Analyst (LPA) Rosaura Valenzuela conducted an annual required inspection. LPA met with Susan Park Administrator and explained the purpose of today's visit. There are currently 89 residents at the facility. LPA utilized the Compliance and Regulatory Enforcement (CARE) tools for the visit today and observed the following: Physical Plant/Environment Safety: The facility is a single story building located in a residential neighborhood consisting of 98 rooms, some of which are being used as model rooms, administration offices and storage rooms. There is one (1) large activity room/living room, across the activity room is a separate area for library, bingo activity area, pool table, computer room and a room designated for arts and crafts. It has a large dining room, laundry room, nurse's station, medication room and a basement parking. It is licensed to care for 120 non ambulatory elderly residents with a hospice waiver for ten (10). Current census is (89) elderly residents. The facility has some Dementia residents. The main entrance/lobby area is used as the central entry point for everyone. A check-in station is set up at the front desk. The interior and exterior physical plant was inspected. Exit doors are free of any obstruction and there are no pools or large bodies of water. Smoke and carbon monoxide detectors are operational. The facility has twenty six (26) fully charged fire extinguishers which were last inspected on Jan of 2024. Administrator stated that the local fire department conducted an annual inspection of the facility in January 2024. The facility has a fire suppression system. Cleaning supplies and toxic substances are inaccessible to residents. Hot water temperature readings measured within the required 105-120 degrees Fahrenheit. The hot water temperature measured at 114 degrees F. Continue on 809-C Personnel Records-Training: Five (5) staff files were reviewed for criminal background clearance and training. Personnel records have health/TB screenings and First Aid/CPR training. Staff employed are over the age 18 and are fingerprint cleared. They have the required training. Resident Records-Incident Reports: Five (5) resident files were reviewed containing admission agreements, Physician's Report, Appraisal, Medical/Functional assessments, Needs and Services Plans, TB clearance, Personal rights, Medical Consent, Medication Records, Restricted Health Care Plans and Hospice Notes/Records were reviewed. Resident Rights-Information: Resident personal rights were posted near the lobby area. The Incident report binder was also reviewed. Planned Activities: There is sufficient space to accommodate both indoor and outdoor activities. Information regarding Dementia is part of the training for direct care staff and is included in the Plan of Operation. An activity calendar was observed posted in the hallway. The facility has a Resident Council. Food Service: The kitchen was inspected and has sufficient supply of 2-day perishable & 7 day non-perishable food. Kitchen, food preparation area, and storage areas were observed to be clean and sanitary. The food is properly stored in the refrigerator (clean, labeled and well maintained). Pesticides and cleaning supplies are kept away from the food preparation areas. Kitchen is kept clean and free from rodents. Medication: Medication is stored in the medication room which is locked and is inaccessible to residents in care. No health and safety issues noted at the time of this visit. Exit interview conducted and a copy of the report was issued.