Routine inspection·February 25, 2025

Licensing Program Analyst (LPA) Zabel Chochian conduct a required annual vist today at this location. LPA Urena was greeted by staff and the Administrator Mariana Romano. Introductions conducted and reason for the visit was explained. At approximately 10:45 a.m., the LPA and Administrator 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. COMMON AREAS: At the time of the visit, living room and dining room furniture was observed to be in good condition. There is a fireplace in the living room, which is screened and inaccessible. The facility maintained a comfortable temperature of 74 degrees. Smoke detector(s) and carbon monoxide detector were tested and operational at the time of the visit. The two (2) fire extinguishers were fully charged and were last serviced 01/27/2025. The LPA observed required postings throughout the common space. KITCHEN: Kitchen appliances were found to be in operable condition. The emergency non-perishable food for residents and staff was found to be sufficient. The fresh food supply was found to be appropriate for the residents currently residing at the facility. Kitchen knives are stored and locked in a kitchen drawer. BEDROOMS: There are six (6) residents’ bedrooms currently occupied as single occupancy. Bedrooms were supplied with sufficient bedding and linens, and there were no visible hazards. Lighting and room temperature were found to be appropriate. There was a linen closet in the hallway with extra towels and linens. There at total of seven (7) bedrooms. One bedroom is designated for staff. BATHROOMS: There are six (6) bathrooms. Each bedroom has a bathroom. The bathrooms were found to have personal grooming, hygiene and sanitary supplies. Hot water temperature measured within the regulation limits (112*f). OUTDOOR AREA: The property is fenced. The LPA and Administrator observed a large water fountain in the front courtyard area with running water; the water fountain is filled with stones so that the water is leveled with the stones in the fountain. Patio furniture in the backyard; shaded area available for resident's comfort. RECORDS: Records review began at 11:45 a.m. Residents’ records were reviewed for, but not limited to care plans, medical records, admissions agreement, consent forms. All residents’ Appraisal and Needs and services plan was missing resident/responsible person signature. Personnel records were reviewed for, but not limited to health assessments, criminal record clearances, first aid/CPR training, and the appropriate training. Last disaster drills conducted in 12/2024. First aid kit observed complete; first aid manual/guide included. MEDICATIONS: Medications review began at 3p.m.; medications are centrally stored and locked in a cabinet in the kitchen; medications are labeled and checked for expiration dates. Following error observed during the medication review: No physician prescription orders for OTC medications and vitamins for two (2) out of four (4) residents medications reviewed. PRN authorization letter not on file for three (3) residents with PRN medications. INFECTION CONTROL : The facility has an adequate supply of Personal Protection Equipment (PPE) and the facility is able to obtain additional supplies as needed. The facility’s cleaning protocol is sufficient. Copy of the following documents were requested to be sent to CCLD: - LIC500 Personnel Report/schedule - Copy of the liability insurance renewal Pursuant to Title 22 Division 6 Chapter 8 of the CA Code of Regulations, the following deficiencies were cited, (refer to LICs 809-D). Exit interview conducted; appeal rights discussed and copy of report provided.