Routine inspection·July 12, 2024

Licensing Program Analyst (LPA) Christian Gutierrez conducted the annual inspection using the Compliance and Regulatory Enforcement (CARE) tools. LPA met with licensee Tiffany Vander at approximately 9:05 AM and explained the reason for the visit. The facility cares for elderly/dementia residents and is approved to care for 6 hospice residents. There are currently 0 residents on hospice. The 1-story facility consist of the following: Four Bedrooms, 3 Resident Bathrooms, dining room, living room, TV room, office, and patio/deck area and attached garage. All resident bedrooms were toured. Bedrooms have the required bed, bedframe, linen, dresser, light, and closet space. During time of visit auditory devises were not working deficiency cited. Resident bathrooms were toured, and the hot water was 106-108.5 degrees which is within the required 105 - 120 degrees. Bathrooms have the required grab bars in the shower and near the toilet. The kitchen was inspected. Freezers are maintained at a temperature of 0-degree F and the refrigerators at a maximum of 45 degrees F. Sufficient supply of 2 days perishable & 7 days non-perishable foods was observed in the kitchen. There is an extra freezer and refrigerator in garage filled with more food. All the appliances are clean and are operating properly. The sharp knives are located in a kitchen drawer that is inaccessible to residents. Cleaning supplies and chemicals are stored in a locked kitchen cabinet and in the garage. There is an additional refrigerator in the garage. The common areas include the living room and dining area. There is a fire extinguisher near the kitchen and another near the garage. The backyard has a shaded patio area with patio furniture. There is a pool that has a fence around the entire perimeter. There is also a fishpond that has a net on top to make the body of water inaccessible to residents. Four (4) client files were reviewed and included physicians report and TB clearance .Four (4) Staff files were reviewed. Last fire/earthquake drill was conducted in May of 2024. Infectious control plan was reviewed. Four (4) residents’ medications were reviewed. Medications are centrally stored and locked MAR log is used. Deficiencies have been noted on LIC 809D under Title 22 Regulations. Exit interview was conducted and a copy of this report, LIC 809D and appeal rights were provided to Tiffany Vander.