Routine inspection·March 10, 2023

On 03/10/23, Licensing Program Analyst (LPA) Ernand Dabuet conducted an unannounced annual required visit using the CARE Inspection Tool. LPA met with the administrator Shirley Danting. LPA explained the purpose of today’s visit. The facility is licensed to operate for (6) non-ambulatory elderly adults over the age of 60 and above Currently, the home has (5) residents and (1) on hospice care. The facility is approved for (4) hospice residents. The facility is a single-story structure located in a residential neighborhood. It consists of the following: five (5) residents' rooms, two (2) common bathrooms, a living area, a dining area, a kitchen, a den, an outside patio, and a garage LPA toured the physical plant. There were no bodies of water on the premises. All rooms were inspected. Beds and bedding supplies were in good condition, adequate lighting was provided, and storage for the resident's personal belongings was observed. Bed linens, comforters, and bath towels were stocked during the visit. Bathrooms were operational. The water temperature measured 109.8 degrees F. A comfortable temperature was maintained in the facility at 73 degrees F. LPA observed the facility to be furnished at the time of the visit. Storage areas for personal hygiene, cleaning supplies, toxins, and sharps objects were stored and not accessible to clients. The kitchen was inspected, and sufficient perishable and non-perishable food was maintained adequately. Fire extinguisher was charged, and smoke detectors and carbon monoxide were operable. A review of Medication Records Administration (MAR) was observed to be maintained in order and accurately. During the visit, LPA observed the facility's infection control practices. LPA observed screening protocols for visitors, staff, and residents, and sanitizing stations in common areas and restrooms. LPA observed the facility has a 30-day supply of Personal Protective Equipment (PPE). All mandated inspection control posters were posted. (Evaluation Report continues LIC 809-C) DEFICIENCIES: LPA identified the following deficiencies during inspection visit: Resident #1-#3: resident with dementia no current medical assessment or appraisals. Staff #5-#7: no current First Aid/CPR certificate on file. According to the California Code of Regulations (Title 22, Division 6, Chapter 8), the following deficiencies has been observed and citation issued (ref. LIC 9099-D). An exit interview conducted with Shirley Danting and a copy of report and appeal rights provided. Note: *Citations not cleared by the due date will be a $100 fine assessed for each citation until it is cleared. Civil penalties will continue to accrue until Proof of Corrections (POC) are cleared.*