Routine inspection·August 15, 2024

Licensing Program Analyst (LPA) Tena Herrera conducted the required annual inspection. LPA arrived unannounced and was greeted by MedTech/Caregiver Yakelin Carrillo, shortly after Luisa Mascardo (Administrator) arrived and assisted with the visit. The purpose for the visit was explained upon arrival. The facility is licensed to serve 70 Ambulatory (of which 50 may be Non-Ambulatory) residents ages 60 and over. With an approved hospice waiver for 20. (there are currently no residents on hospice at the facility). This is a two-story facility located in Bellflower, Ca. A tour of the facility includes: First Floor: Front Office, Conference Room with Storage Room and File Room, Activity Room, Storage Closets Under Parking Port, Laundry Room, Dining Hall, Kitchen, Medication Room, Linen Closet and Outdoor Patio Areas. There are 3 buildings on first floor (A,B,F&G) totaling 16 Resident Rooms, 6 Full Bathrooms, 4 Half Bathrooms. Second Floor: 3 buildings totaling 28 Resident Roo ms, 8 Full Bathrooms, 4 Half Bathrooms, Patio Area and Storage Closets. There are call buttons in and smoke detectors in each unit and there is an emergency sprinkler system throughout facility. 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 gloves while assisting residents’ medications. Staff are still cleaning and disinfecting throughout the day. Facility has sufficient PPE supplies and has an Infection Control Plan maintained at the facility. Operational Requirements: The facility maintains a current Plan of Operation and an approved Fire Clearance. The facility maintains the required Liability Insurance. Physi cal Plant & Environment Safety: LPA toured facility, a total of 14 residents’ bedrooms/units were checked and had the required closet/drawer space to accommodate each resident comfortably available. The resident rooms each had a signal system with call buttons that were tested an operating properly. There are smoke detectors, carbon monoxide detectors and an emergency sprinkler system throughout the facility that are operable and in compliance. (Continued on 809C) Physical Plant & Environment Safety (continued): The fire extinguishers were observed and are fully charged. No bodies of water were observed at facility. Hot water temperature was tested throughout the facility and measured within the required range of 105-120 degrees. The passageways are free of debris/hazards and are free of obstruction All storage areas for cleaning solutions, toxins, knives, and hazardous items are properly stored are inaccessible to residents. Staffing : There appears to be sufficient staffing at all times with at least one nighttime staff that is able to operate the facility signal system, is familiar with emergency procedures and has a current CPR and First Aid training on file. Personnel Records-Training : Staff files are maintained in a locked storage room within the Conference Room. Staff files observed during today’s visit have criminal record clearance, health screening and current First Aid/CPR/AED certificates (with the exception of 1 staff that was missing First-Aid certificate, cited on 809-D), dementia training, and sufficient on-going training. Administrator Luisa Mascardo certificate expired on 5/28/24, but was able to provide proof of pending renewal and all current training were within the personnel file, CCL website showed pending renewal, expiration of 5/28/26. Resident Rights-Information: Personal Rights and Complaint signage are posted within the Dining Hall. Resident Records-Incident Reports: Resident files are maintained in the Administrators Office and have the following documents in their files - Admission Agreements, Identification & Emergency Information, current Physician's Report, Pre-admission appraisal/Appraisal Needs & Services Plan (1 of the resident files reviewed were missing their Physician Report, details cited on 809-D page). Planned Activities: LPA observed the Activity Schedule posted in the Dining Hall and toured the Activity Room, there were books, magazines, supplies for activities, board games and puzzles readily available for residents. The facility has a designated Activity Director. Food Service: The kitchen was observed for the ability to prepare and serve food. LPA observed an appropriate food supply of two (2) days of perishables and one week (7 days) of non-perishables. Incidental Medical & Dental: Medications are centrally stored in locked Medication Room and in their original containers. Disaster Preparedness: The facility has an Emergency Disaster Plan posted with contact numbers and at least 2 relocation sites. Facility maintains documentation of the required emergency drills. Residents with Special Health Needs: The facility is in communication with the Home Health agency to ensure the needs of residents are being met. Per California Code of Regulations, Title 22, and California Health and Safety Code, the deficiencies observed during the visit are documented on 809D. Exit interview was held and a copy of the report and appeal rights were provided Administrator Luisa Mascardo