Routine inspection·November 12, 2023

On 11/15/23, LPA España created an amendment to the Annual report created 11/12/23. This report serves as an Amendment to annual report created on 11/12/23. This addendum is written to clarify findings description and does not change the annual report findings recorded on 11/12/2023. Report to be signed by authorized representative. ** On 11/12/2023 at 2 pm Licensing Program Analyst (LPA) David España conducted an unannounced Required-1-year annual visit. Upon arrival at the facility, LPA España conducted a risk assessment at the front door. Based on the assessment, the facility is clear of Covid-19 infection (No COVID-19 cases). LPA verified that the facility has an approved mitigation plan report. LPA was granted access and allowed to enter the facility to conduct the inspection.LPA met with Staff #1, and they toured the inside and outside grounds of the facility. The Residential Care Facilities for the Elderly (RCFE) facility is licensed for age range 60 and over, approved for (6) non-ambulatory, of which (4) can be bed-ridden, approved hospice waiver for (4), rooms #1, #2, and #3 are approved for bed ridden. LPA observed five (5) residents and two (2) direct caregivers during the visit. During the tour, LPA did not observe bodies of water or obstructions on the premises. All rooms were inspected. Beds and bedding supplies were in good condition, adequate lighting was provided, storage for resident personal belongings was observed. Bed linens, comforters, and bath towels were adequately stocked at the time of visit. A comfortable temperature was maintained in the facility. There are no security bars or weapons on the premises. Resident bathrooms were checked, sufficient liquid soap and paper towels were observed. Toilets and water faucets worked properly, grab bars were secure, the shower was free of mold/mildew, and a non-skid mat was in place. The water temperature measured at 140.1 degrees Fahrenheit. A comfortable temperature was maintained in the facility. Smoke detectors are interconnected and operational.LPA observed the facility was found to be appropriately furnished at the time of visit. Storage areas for personal hygiene, cleaning supplies, toxins, and sharps objects were stored and not accessible to residents. The kitchen was inspected and there is sufficient perishable and non-perishable food supplies. The facility has (2) fire extinguishers that were charged, smoke detectors, and carbon monoxide were operable. The facility conducted a Fire/Safety Drill on 7/11/2022. Evaluation Report Continues on LIC 809C All mandated inspection control posters were posted. The facility has an approved Mitigation Plan Report on file with CCLD. There were deficiencies were observed during today's inspection. LPA and S#1 observed the hot water: At 2:15 PM, LPA measured the hot water temperature in bedroom bathroom #4 at 140.1 F degrees, which is not within Title 22 and poses an immediate danger to the health and safety of five (5) out of five (5) residents in care. LPA and S#1 observed ramps with potential hazards by resident room #3. LPA met with Staff #1 and reviewed records of S#1, S#2, and S#3 which were missing Health Screening Report/Tuberculosis (TB) Clearance (LIC 503)-facility personnel, (1st aid) Verification of first aid training for staff providing care, LIC9052 etc. LPA met with Staff #1 and toured the inside and outside grounds of the facility. LPA and Staff#1 did not observe PUB475 in the main entryway of the facility. LPA met with Staff #1 and did not observe annual fire drill with sign and dated plan as indicated Title 22 regulations. Advisory Notes - Technical Assistance were issued, please see LIC9102-AN. Type B deficiencies were issued, please see LIC-809D Physical Plant/Environmental Safety - Type A: 87303(e)(2) - Physical Plant/Environmental Safety - 87307(d)(4) Personnel Records/Staff Training - Type B: 87412(a) Resident Rights/Information - Technical Assistance: 87468(c)(2)(A) Disaster Preparedness - Technical Violation: 1569.695(d) An exit interview was conducted with Staff #1 and a hard copy of the report was furnished.