Routine inspection·May 15, 2025

Licensing Program Analysts (LPAs) Bennette Pena and Gabriela Castro conducted an unannounced Required-1 year visit. LPAs were met by Marebeth Mallare, Administrator and Leonardo Mallare, Caregiver and explained the purpose of the visit. The facility cares for residents age range 60 and over and licensed for (5) non ambulatory, (1) bedridden resident (shall be in bedroom #3), and approved for (6) hospice residents only. There are currently (3) residents on hospice. LPAs utilized the Compliance and Regulatory Enforcement (CARE) tools for the visit today and observed the following: Infection Control: Infection control practices and Personal Protective Equipment (PPEs) were observed. Staff are trained on the emergency infection control plan and following hand hygiene techniques. Emergency and disaster plan was completed and up to date. Operational Requirements: The Infection Control Plan has been reviewed and updated. A Hospice Waiver for (6) is approved. Liability insurance policy is in place and expiring on 06/19/2025. The facility does not handle cash resources for the residents. Latest fire drill was conducted on 03/01/2025. Physical Plant/Environment Safety: The facility is a single story home located in a residential community. The home consists of living room, dining area, kitchen, (4) resident bedrooms, one of the bedrooms has a fireplace that is adequately screened, (4) bathrooms, back yard with swimming pool that is fenced and inaccessible to residents, and laundry area in the attached garage. The interior and exterior physical plant was inspected. Resident bedrooms were toured. Each bedroom has a smoke detector, bed, linen, dresser, light, and sufficient closet space. Bathrooms have the required grabs bars and non-skid materials. The laundry room is clean and has cleaning supplies inaccessible to residents. The kitchen was inspected. There is sufficient perishable and non-perishable food. All the appliances are cleaning and are working properly. The common areas such as activity room and dining room are clean and have the required furniture. The backyard has a shaded area and sitting area. There is also a swimming pool in the backyard Exit doors have auditory devices that were operating at the time of the visit. There are cameras in the front door, backyard, living room, dining area and kitchen. There were no cameras seen in private areas. Exit doors are free of any obstruction. Cleaning supplies and toxic substances are inaccessible to residents. The facility has (3) fully charged fire extinguishers, last serviced on 01/15/2025.*****CONTINUED ON LIC809-C***** Staffing: A total of three (3) caregivers including the Administrator provide care and supervision to the residents. Staff employed are over the age of 18 and have criminal background clearance, fingerprint cleared, have the required training and associated to the facility. Personnel Records-Training: Three (3) staff files were reviewed for criminal background clearance and training. Personnel records have health/TB screenings. Administrator has completed the required Administrator courses but has not submitted the certification renewal. Resident Rights-Information: Resident personal rights are posted. Visiting policy is posted at a location that is visible and accessible to residents and families. Physician orders for use of full/half bed rails were reviewed in residents files. LPAs conducted (3) resident interviews. Planned Activities: Information regarding Dementia is part of training for direct care staff and is included in the Plan of Operation. The facility provides sufficient space to accommodate both indoor and outdoor activities. Food Service: The kitchen was inspected and has sufficient supply of 2 day perishable & 7 day non-perishable food. Kitchen, food preparation area, and storage areas were observed to be clean and sanitary. The food is properly stored in the refrigerator (clean and well maintained). Pesticides and cleaning supplies are kept away from the food preparation areas. Plates, cups and utensils are kept cleaned and stored properly. Incident Medical and Dental: All residents have Restricted Health Care Plan and Needs and Services Plan on file. Home Health personnel services the residents in the facility. Hospice and Home Health Nurses conduct visits on a regular basis. (5) residents' medications were reviewed with no issues observed. Resident Records-Incident Reports: Five (5) resident files were reviewed containing admission agreements, Physician's Report, Medical/Functional assessments, Needs and Services Plans, TB clearance, Personal rights, Medical Consent, Medication Records, Disaster Preparedness: The facility has a complete Emergency Disaster and Mass Casualty Plan containing emergency evacuation, storage and preservation of medications, operation of manual assist devices. The facility conducts emergency drill on a quarterly basis for all staff and residents. Residents with SHN: (3) Residents are on hospice and palliative care. Per California Code of Regulations, Title 22, deficiencies were cited. An exit interview was conducted and a copy of the report and appeal rights were provided to the Administrator, Marebeth Mallare.