Routine inspection·October 8, 2024

On 10/08/24, Licensing Program Analyst (LPA) Ernand Dabuet conducted an unannounced annual required visit using the CARE Inspection Tool. LPA met with administrator Cheresa Reyes. LPA explained the purpose of today’s visit. The facility is licensed to operate for (6) non-ambulatory of which (1) maybe bedridden elderly adults ages 60 and above. Currently, the facility has (2) hospice resident in care. The facility is approved for (6) hospice residents. The facility consists of one-story level: (4) resident bedrooms, (2) staff bedrooms, (1) bathroom, kitchen, dining room, living room/activity room and an outside patio. LPA toured the physical plant. There were no bodies of water on the premises. All rooms were inspected. Beds and bedding supplies were in operational condition, lighting was provided, and storage for the resident's personal belongings was observed. Bed linens, comforters, and bath towels were available during the visit. Bathrooms were operational with water temperature measured at 114.8 degrees F. A comfortable temperature of 77 degrees F. was maintained in the facility. LPA observed the facility to be furnished at the time of the visit. Storage areas for personal hygiene and sharps objects were stored and not accessible to residents. The kitchen was inspected, and sufficient perishable and non-perishable food was maintained adequately. Fire extinguisher were charged. The facility has conducted emergency fire drills on 10/01/24. A review of the Medication Administration Record (MAR) was observed to be maintained in order. (Evaluation Report continues LIC 809-C) LPA observed First Aid Kit was maintained. A working landline phone was operational. The facility had operational smoke and carbon monoxide in bedrooms and common areas. The facility has current liability insurance on file effective 08/19/24 through 08/19/25. The facility is current with CCLD annual license dues. 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. All mandated inspection control posters were posted. An audit of residents #1-#6 (R1-R6) service files and staff #1-#5 (S1-S5) personnel files. The facility has the current administrator's certification on file for Gian Paula Dizon #6071096740 Expiration 07/29/26 and Cheresa Reyes #6004109740 Expiration 11/20/24. DEFICIENCIES: No window screens for Activity Room and for resident room #2. Window screens require replacement for Hallway and Kitchen. Resident #6 not on hospice care had full extended bed rails without physician's prescription. Obstruction of exit passageway for room #3 with end table furniture. Refilled medications for resident #3 with dementia were stored in a unlocked hall closed accessible to residents in care According to the California Code of Regulations (Title 22, Division 6, Chapter 8), the following deficiencies has been observed and citation issued (ref. LIC 809-D). An exit interview conducted with Cheresa Reyes, 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. *