Post-licensing visit·December 13, 2022

On 12/13/22, Licensing Program Analyst (LPA) Ernand Dabuet conducted an unannounced post licensing visit using the CARE Inspection Tool. LPA met with assistant administrator Sheila Auingan and explained the purpose of today’s visit. The facility is licensed to operate for (27) elderly non-ambulatory adults of which (5) may be bedridden. The facility is approved for (8) hospice residents. Currently, there are (3) hospice residents. The facility is a two-story structure located in a residential neighborhood. It consists of the following: (17) resident's rooms with a bathroom in each room, a living area, a dining area, a kitchen, and an outside patio area. LPA and administrator 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, storage for resident personal belongings was observed. Bed linens, comforters, and bath towels were adequately stocked at the time of visit. Bathrooms were found to be within Title 22 regulations and were clean and operational. The hot water temperature was tested for rooms: #5 112.9 F; #4 114.6 F; #3 109.6 F; #2 105.0 F; #11 115.0 F, and #17 117.6 F A comfortable temperature of 74 degrees was maintained in the facility. LPA observed the facility to be appropriately furnished at the time of visit. Storage areas for personal hygiene, and sharps objects were stored and not accessible to residents. The kitchen was inspected and there is sufficient perishable and non-perishable food available maintained properly. The facility has several fire extinguishers that were charged, smoke detectors, and carbon monoxide was operable. The facility conducted a Fire/Safety Drill on 11/01/22. A working landline telephone remains available. The facility maintains a PRN Medication Log. Evaluation Report Continues on LIC 809-C DEFICIENCIES: Based on record reviews, LPA identified staff #2 through #10 (S2-S10) did not have a Criminal Clearance Background Clearance Transfer for all (9) employees and were not associated at this facility. The administrator is being cited according to Administrator's Qualifications Regulations 87405 resulting in multiple deficiencies cited. Based on interviews, observation, and record reviews the licensee violated the California Code Regulations (CCR) of Title 22, Division 6, Chapter 8. IMMEDIATE CIVIL PENALTY Deficiency are issued and an exit interview is conducted with Sheila Auingan. A copy of this report, appeal rights, and civil penalty were provided.