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Inspection visit

Routine inspection

SHALOM ELDERLY CARE, INC. 4License 1976086534 citations on this visit
4 citations recorded

Inspector’s narrative

What the inspector wrote

Licensing Program Analyst (LPA) Elsie Campos arrived unannounced to conduct a required annual visit. The LPA met with Administrator Doris Almario and explained the reason for the visit. The LPA toured the facility to ensure there are no health and safety hazards and to ensure regulatory compliance. KITCHEN : Knives and chemicals are locked inaccessible. Appliances were in operable condition. The facility has a sufficient supply of perishable and non-perishable food. A carton containing 5 dozen eggs was found stored in a kitchen cabinet. Eggs are to remain refrigerated per the food safety guideline label indicated on the front of the egg carton. Administrator indicated the eggs had been bought on Sunday. Eggs were appeared unused, the carton was complete and sealed at the time of the visit. Administrator was reminded to ensure that labels are read appropriately for food storage requirements. BEDROOMS : The facility has six single-occupancy resident rooms and two staff rooms all which were furnished appropriately; beds had clean linens and rooms had sufficient lighting. All direct exits were clear and no obstructions were noted. RESTROOMS : Five out of six resident rooms have an en suite restroom and there are two common restrooms, one located in the hallway and the other located in the laundry room. Restrooms were clean and sanitary with grab bars and non-skid surfaces. Between 10:55 a.m. and 11:08 a.m., water temperatures measured between 103.6 F and 113.5 F. Restrooms were fully stocked. Hand-washing signs were observed. COMMON SPACES : Smoke detectors and common monoxide detector were operable at the time of the visit. Fire extinguishers were fully charged however last purchased on 3/31/2021 and in need of service or replacement. The backyard had furniture and a covered area for resident use. The side gate door was self-latching. No bodies of water noted. The LPA observed one dented window screen and multiple windows with spiderwebs and debris. Administrator was reminded to ensure that windows are cleaned regularly. Upon LPA’s arrival it was determined that Staff #1 (S1) was not associated to the facility. The Administrator indicated that S1 was associated to a partner facility however had not had clearance transferred to this facility. 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 on the front door and throughout the facility. Facility has a sufficient supply of PPE. The facility’s cleaning protocol is sufficient. Staff continue to document temperatures of staff and residents on a daily basis. There was record of staff and resident vaccinations. The LPA discussed changes around testing, visitation and vaccine requirements. The facility recently managed COVID-19 active cases and the facility complied with all requirements set forth by the local health department and licensing. The facility's procedures as it pertains to infection control are adequate. The following deficiencies were observed (See LIC809-D) and cited from the California Code of Regulations, Title 22. Exit interview conducted. A copy of the report and appeal rights were provided.

Citations

4 citations recorded*CCLD

What does Type A vs Type B mean?

Type A. Serious citation. Imminent or substantial risk to children. The regulator requires corrective action immediately and may impose a civil penalty.

Type B. Lower-severity citation. Corrective action required, no imminent risk. The regulator monitors compliance on the next visit.

  • 87202(a)Type B

    Based on observation, licensee failed to maintain an appropriate fire extinguisher as the fire extinguisher was last serviced 3/31/2021, which poses a potential health and safety risk to residents in care.

  • 87303(c)Type B

    Based on observation, the licensee did not comply with the section cited above as one window screen was observed to be dented allowing for insects to enter if window is left open additioanlty window screens were observed to have spider webs and debris which poses a potential health, and safety risk to persons in care.

  • 87355(e)(2)Type A

    Based on observation, interview, and record review, the licensee did not comply with the section cited above as when LPA arrived at the facility Staff #1 (S1) was working and has been working at the faiclity since June and associated to a partner facility, but S1's criminal background clearance was not transferred to this facility prior to working with residents, which poses an immediate safety risk to persons in care.

  • 87555(b)(8)Type B

    Based on observation, the licensee did not comply with the section cited above as the LPA observed a carton of 5 dozen eggs to be stored in a kitchen cabinet. Eggs had a label indicating that they are to remain refrigerated at or below 45 degrees F to prevent illness from bacteria which poses a potential health and safety risk to persons in care.

FAQ · About this visit

Common questions about this visit

What happened during the October 18, 2022 inspection of SHALOM ELDERLY CARE, INC. 4?

This was a inspection inspection of SHALOM ELDERLY CARE, INC. 4 on October 18, 2022. 4 citations were issued: 1 Type A (serious) and 3 Type B.

Were any citations issued to SHALOM ELDERLY CARE, INC. 4 on October 18, 2022?

Yes, 4 citations were issued (1 Type A, 3 Type B). The first citation was for: "Based on observation, licensee failed to maintain an appropriate fire extinguisher as the fire extinguisher was last ser..."

What type of inspection was this?

This was a inspection inspection. inspection inspections are conducted by CCLD as part of their licensing oversight.

SourceView on CCLDView original report

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