Post-licensing visit·December 26, 2023

Licensing Program Analyst (LPA) V. Maldonado made an unannounced visit at the facility for the purpose of conducting the required Post-Licensing inspection, using the Compliance and Regulatory Enforcement (CARE) Tool, to evaluate the facility. LPA Maldonado met with Administrator, Barbara Boiston, and explained the purpose for the visit. During today's visit, LPA Maldonado conducted a tour of the physical plant with Administrator, observed the facility food supplies, reviewed (6) resident medications, (6) resident files, (3) staff files, and conducted interviews with (3) staff, and attempted interviews with (6) residents. The facility is a single-story home, operating as a Residential Care Facility for the Elderly. It is licensed to serve (6) older adults, ages 60 and over. There is a fire clearance approved for (6) non-ambulatory residents. It has an approved Dementia Care Plan and a Hospice Waiver approved for (6) residents. There are currently (3) resident receiving hospice services. An Infection Control plan has been submitted to the department for review. The facility has an active and current liability insurance policy on file. LPA observed all resident bedrooms to have the required furniture, sufficient lighting, and closet/storage space. There are (2) full bathrooms in the home- both equipped with required grab bars and non-skid mats. The hot water was tested and measured at 107*F, which is in compliance. Food supplies was observed and was sufficient as required. Emergency food supplies and water were available. A pool was observed in the backyard- fenced and inaccessible to residents in care. Fire extinguishers were observed throughout, with current inspections and were fully charged. All sharps and cleaning supplies/toxins were observed to be locked and inaccessible to residents. Smoke/carbon monoxide detectors were observed in each room- tested and operational during today's visit. Auditory devices were observed at all entrances/exits of the home and operational. (6) resident files and (3) staff files were reviewed and observed to be complete with all required documentation. At 2:15PM, LPA reviewed (6) resident medications, and discovered (1) pill, outside of it's casing, dropped inside a drawer behind a box of gloves, where pre-punched medications were stored. Staff and administrator reviewed medication while LPA observed. It was determined that (1) medication for (1) of (6) residents was missing, as it was supposed to be administered in (2) pills at a time- this medication was administered and documented incorrectly. Per California Code of Regulations, Title 22, citations will be cited on the LIC809-D page. An exit interview was conducted and a copy of this report and appeal rights were provided.