Routine inspection·February 9, 2024

Licensing Program Analyst (LPA) Brian Balisi arrived at the facility unannounced to conduct a required annual inspection. Upon arrival LPA met with Administrator Brandon Zinkofsky and explained the reason for the visit. At approximately 11:10am, 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. The carbon monoxide and smoke alarms were tested and all functioned properly. The fire extinguisher was fully charged and  last serviced in Jan 20, 2024. LPA observed Kitchen to be inaccessible to residents at this time. The kitchen appeared to be clean and the appliances and fixtures functional. Properly labeled medications and sharp objects were observed to be locked in a cabinet to the right of the fridge.  LPA observed a sufficient amount of perishable food stored in the fridge and non-perishable food  properly stored in a pantry inside of the laundry room on the exterior of the kitchen.Laundry area  located between living room and kitchen. LPA observed this room to be inaccessible to residents at this time. Cleaning supplies and detergents were observed locked in a cabinet below the water tank. There were (7) bedrooms total with (1) bedroom designated for staff use, which was located next to the kitchen. LPA observed staff room to be  empty at this time. All bedrooms for clients use were properly furnished and had appropriate bedding and linens. At approximately 11:40am, LPA observed (4) residents sleeping in their bedrooms. There were two bathrooms designated for resident use. Both bathrooms were clean, properly supplied and had functional fixtures. At 11:15am  Hot water temperature was measured at 123 degrees Fahrenheit. Administrator adjusted the temperature during the visit. Common Areas:  These included the living rooms and dining areas. The common areas were properly furnished and appeared to be relatively clean at this time. At approximately 12:15pm, LPA observed resident eating lunch at dining table. Surrounding Grounds: LPA observed  shaded patio furniture appropriate for outdoor use and plenty of room for outdoor activities. LPA did not observe any obstructions to emergency exits at this time. There is a detached garage located on the property. LPA observed garage to be used for storage of unused furniture, medical supplies and decorations. Records review began at 12:00pm, SIX (6)  resident records were reviewed for, but not limited to: appraisals, medical records, admissions agreement, consent forms. Records review revealed on 1/23/2023, Resident 1 (R1) was admitted into the facility and physician's report dated 01/18/2023, lists R1 as having no capacity for self-care which is a prohibited health condition. The licensee did not submit an exception request to admit and retain the resident with a prohibited health condition. Five (5) Personnel records were reviewed for, but not limited to: personnel records, health assessments, criminal record clearances, first aid/CPR training, and the appropriate training. All files were observed to be in order at this time. During today’s visit, LPA spoke with the Administrator regarding the facility’s infection control practices. Upon entry, the facility has a central entry point for symptom screening, temperature checks, and a sanitation station. LPA observed 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. If needed, the facility has the capacity to designate a single isolation room if the facility has a confirmed case of a communicable disease. The facility has not had a confirmed case of a communicable disease at this time; however, the facility’s policies and procedures as it pertains to infection control are adequate at this time. Medications review began at approximately 2:00pm The medications are centrally stored in a locked cabinet to the right of the fridge and inaccessible to residents in care. Medications were observed to be properly documented on the centrally stored medications and destruction record at this time Continued from 809-C Between 11am - 03:00pm the LPA interviewed four (4) staff members and one (1) resident. LPA obtained the following documents - Census, Staff schedule, Emergency Disaster plan and updated Limited Liability insurance. The following deficiencies were observed (See LIC 809-D.) and cited from the California Code of Regulations, Title 22 and California Health and Safety Code. Failure to correct the deficiencies may result in civil penalties. Exit interview conducted. A copy of the report and appeal rights were provided.