Routine inspection·July 16, 2024

Licensing Program Analyst (LPA) Kelly Dulek arrived unannounced to conduct a required annual visit. The LPA met with Associate Executive Director (AED) Edward (Eddie) Ocegueda and informed them of the reason for the visit. LPA was informed Executive Director is unavailable today. At 10:45AM, the LPA and the Associate Executive Director toured the physical plant areas inside and outside to ensure there are no health and safety hazards and community is in compliance with Title 22 Regulations. The following was observed: Fire extinguishers throughout the facility buildings were observed to be fully charged and last serviced 08/07/2023. The facility's fire safety system 5-year inspection was conducted on 12/06/2019 by Fraker Fire Protection; all relevant systems passed at that time. The annual inspection was conducted by Fraker Fire Protection on 05/23/2024, noting one area of concern in building G. Proof of repair will be provided to LPA during annual continuation. Common Areas: The main facility structure is a three-story building. There are resident rooms on all three floors, units are designated for assisted living residents on all three floors. In addition, there are additional resident units in six (6) stand-alone buildings. Common spaces on the first floor include the theater, salon, secured pool, and spa. The second floor includes the reception area/lobby, library, activity rooms, fitness room, and physical therapy room. The third floor includes the kitchen/dining services, and activity rooms. There were no obstructions and/or tripping hazards throughout the facility. At 12:22PM, the doors to the fitness room were observed to be propped open with no staff present; 2 pairs of scissors and 2 screwdrivers were observed accessible on top of a desk. At 12:26PM, the ceiling over an open common area in the second floor was observed to be covered in plastic and dripping water. AED indicated there had been a leak in the third floor kitchen and the leak has since Continued on LIC 809-C been resolved, however, repairs on the ceiling have not been completed to date. Planned activities are offered. Activity schedule is posted throughout the facility. The LPA observed staff engaging residents in group activities. Kitchen: Dining room is located on the third floor and was observed to be clean and sanitary. At 03:45PM, LPA observed a small fruit/drain fly in the kitchen area and immediately outside the kitchen, in the server station near the juice dispenser, LPA observed a large number of small flies, both flying about and on the ceiling. The facility had a sufficient supply of two-day perishable and seven-day nonperishable food. The menu was posted, and the facility offers daily specials and a standard selection at every meal. Snacks and beverages are available for residents in the Bistro area on the 2nd floor. Resident Units: The LPA and Associate Executive Director toured 14 (fourteen) randomly selected resident units throughout the community. Rooms were furnished with clean linens, appropriate furniture and sufficient lighting. Restrooms: The LPA and Associate Executive Director observed restrooms in 14 (fourteen) resident units. All restrooms were fully stocked with supplies. Restrooms were clean and sanitary and in operating condition with grab bars and non-skid surfaces in the bathing unit. Water temperature was tested throughout the visit and measured at 138.4 degrees F at 11:42AM in room F7 and 133.1 degrees F at 11:49AM in room E1. Outside areas: The LPA and Associate Executive Director toured the outside areas and courtyards. There was appropriate outdoor furniture, with a covered shaded area for residents observed in several facility courtyards. There is a locked pool for resident usage with appropriate fencing and it was locked inaccessible. Parking is available for residents and visitors. Files: Residents records review began at 02:30PM, 10 (ten) records were reviewed for, but not limited to: care plans, medical records, admissions agreement, consent forms. Resident records were in order. Personnel records will be reviewed during Annual Continuation Visit. Interviews: LPA interviewed 6 (six) residents during today's visit. LPA will conduct staff interviews during the Annual Continuation visit. Medications: Medications will be reviewed during Annual Continuation Visit Continued on LIC 809-C Infection Control Plan/Emergency Disaster Plan: Infection control plan was not provided today and will be reviewed during Annual Continuation visit. LPA reviewed the facility's Emergency Disaster Plan, which was recently updated, however, the facility is utilizing an outdated form. LPA will email the updated form. Disaster drills are conducted weekly, with the last documented drill conducted on 07/08/2024. Documentation: The LPA obtained a copy of the facility's liability insurance, resident roster, and staff roster. Pursuant to Title 22 of the CA Code of Regulations, the following deficiencies were cited (refer to LIC 809-D): Exit interview conducted. A copy of the report and appeal rights were reviewed and provided.