Routine inspection·June 12, 2024

Licensing Program Analyst (LPA) Sanjay Vaid conducted a subsquential visit to complete the annual inspection at 1:30PM. LPA arrived unannounced and met with Staff, Naylet Velazquez and Administrator, Rosalie Sandoval, assisted with the visit. The purpose for the visit was explained. The facility is licensed to serve 60 non-ambulatory residents ages 60 and over. There is a hospice waiver approved for 5 residents. The facility currently has 2 hospice residents. The facility is licensed to serve 40 non-ambulatory residents ages 60 and over with an approved hospice waiver for 5 residents. The facility is a 1 story building located in a residential area, it has 20 shared rooms, an activity room, a dining room with kitchenette, a medication room, and a back outdoor area. Facility does not have a kitchen and per the plan of operation they receive food prepared in their sister facility for all resident meals. On 05/30/24 LPA reviewed 3 domains of the CARE Tools: operational requirements, physical plant and environment and residents with special health needs. On todays visit LPA utilized the Compliance and Regulatory Enforcement (CARE) tools for the visit today and observed the following: Infection Control: The facility staff are using appropriate hand hygiene and wearing gloves while assisting residents. Staff are continuing to clean/disinfect every 2 hours as documented. Facility has sufficient PPE supplies and has an Infection Control Plan. They are continuing to follow the strictest guidance for any infectious outbreaks. Staffing: There is sufficient staffing at the facility. The administrator's (Rosalie Sandoval) certificate expires on 1/24/24. Staff employed are over the age of 18 and are fingerprint cleared and associated to the facility. Personnel Records-Training: Staff files are maintained at the facility. Staff have current CPR or first aid training and sufficient on-going training that meets the annual requirement. Resident Records-Incident Reports: Resident files are maintained at the facility and have the following documents in their files - Admission Agreements, Identification & Emergency Information, Physician's Report, Pre-admission appraisal, and Resident rights. Continued on 809 C.... Resident Rights-Information: The Complaint poster, Local Ombudsman, and Residents personal rights are posted. Planned Activities: Facility has sufficient space to accommodate indoor and outdoor activities. There are sufficient supplies and equipment to meet resident's physical capability. Food Service: LPA observed sufficient food supplies of 2-day perishable and a week of non-perishable items at the sister location next door. The facility stores the emergency food supplies on site. Incidental Medical & Dental: The medications are centrally stored and in their original containers. The facility uses the Medication Administration Record (MAR) log to document medications given. During the visit today, LPA reviewed 4 residents' medication and they are being administered as prescribed by the physician. Disaster Preparedness: The facility has the updated Emergency Disaster Plan posted with contact numbers and at least 2 relocation sites. Last fire inspections was conducted on 4/24/24. Last fire drill was conducted on 4/10/23, earthquake drill was conducted on 04/25/24. Medication room was observed inaccessible to the residents. Medication was reviewed for 4 residents. LPA reviewed 4 resident/staff files and interviewed 4 residents and 4 staff. Administrators certificate #6012456740 is in process of renewal, post mark for renewal sent is 12/14/23. Liability Insurance policy expires 05/08/2025. Surety bond insures $8000.00 per incident dated 01/15/2016. No deficiencies were issued today. An exit interview was held and a copy of this report was given to the administrator.