Routine inspection (multi-day)·August 8, 2024

On 08/08/24, Licensing Program Analyst (LPA) Regina Cloyd conducted an annual continuation and met with Caregiver Mignon Diaz . LPA Cloyd spoke with Administrator Virginia Asis over the phone. The facility is licensed to serve clients aged 60 and over, six non-ambulatory. They have an approved Hospice Waiver for six residents. Annual Fees are current. The facility is a single-story structure located in a residential neighborhood. It consists of the following: three (3) bedrooms, 2 bathrooms, living room, kitchen, dining room, family room, garage, and a shaded area. On 08/07/24, the Caregiver and Administrator accompanied LPA inside and outside the facility during this inspection. Outside grounds were toured and no bodies of water were observed. Resident bedrooms had the required bed linens and closet/drawer space to accommodate each resident comfortably. There are no security bars or weapons on the premises. Resident bathrooms were checked. Toilets and water faucets worked properly, grab bars were secure, shower was free of mold/mildew and a non-skid mat was in place. Resident bath towels, toiletries and personal hygiene supplies were adequately stocked. Continue to LIC809-C. Common areas were clean and clear of hazards, doorways were free of obstructions. LPA toured the kitchen area and observed knives and toxics were kept in locked storage cabinet. First Aid kit was available. One fire extinguisher, last serviced August 11, 2023 was observed in the kitchen area. Staff tested the smoke detectors in the house. Device was functional. Two (2) resident records were reviewed and, 2 out of 2 resident records had medical assessments. Two residents’ medication was reviewed. Four (4) staff records were reviewed. Deficiencies are being cited based on LPA observation, interviews conducted and record review in accordance with the California Code of Regulations, Title 22, see LIC809D. A violation regarding criminal record clearance warrants an immediate civil penalty of $500.00 and is hereby assessed, see LIC421IM. On 08/07/24, LPA Cloyd did not observe Staff #5’s (S5) health screening with TB results nor criminal record clearance and association to the facility. The facility did not have a personnel record on site for S5. S5 was working at the facility on 08/07/24 and 08/08/24. On 08/07/24, during record review, LPA did not observe an allowable health care plan for resident #1 (R1). Interviews confirmed that R1 requires assistance with injections from the Home Health Nurse and from the staff. On 08/07/24, during the facility tour, LPA measured water temperate at 142.8. Staff adjusted the water temperature on 08/07/24 afternoon.. Continue to LIC809C. An exit interview was conducted , plans of Correction were developed, technical assistance provided, and a copy of this report and appeals was discussed with Administrator Virginia Asis and left with Caregiver Mignon Diaz.