Pre-licensing visit·November 15, 2021

Licensing Program Analyst (LPA) Fernandes-Goes conducted a pre-licensing inspection and met with Licensee/Administrator Cleda Odiwe. This is a change of ownership. Fire clearance has been approved for 10 non-ambulatory residents by the County Fire Department. LPA will conduct a component III orientation with Cleda & Ken Odiwe Administrator/Licensee. There is a total of 7 residents and no residents under Hospice care. Facility tour/inspection began at 10:45 AM: Facility is a one floor facility. LPA toured the facility on 11/15/2021 with Licensee/Administrator Cleda Odiwe; facility was found to be at a comfortable temperature with all exits free from obstruction. Fire Extinguisher was found to be last charged on 06/2021. Sample test of facility smoke detectors and carbon monoxide detectors were found to be operational. Sample hot water temperature measured 111.7 degrees F within Title 22 acceptable regulation of 105 to 120 degrees F in 1 of 1 resident’s bathroom faucet. The facility has special care plan of operation and programming for residents with dementia. Facility does grocery shopping on Tuesdays. Food stored in the kitchen refrigerator were properly stored as per regulations. LPA observed that provisions are made for individuals with special dietary needs. Food is available for residents any time of the day. Toxins are stored in a locked cabinet in the office room. There was a supply of cleaners, hygiene products and paper products available for residents. All bathrooms designated for residents at the facility were supplied with paper towels and hand soap dispensers. Bathrooms were equipped with necessary grab bars, and non-slip floors/mats were present in the bathroom shower. A sample tour of resident’s bedrooms was conducted, and bedrooms inspected have lighting & appropriate furnishing. Continue LIC 809-C Facility floor includes kitchen, laundry room, living room area, bathrooms, office room, dining room, and resident's bedrooms, and bathrooms. There is outdoor space for activities. Resident's & Personnel records, medication, first aid supplies, and toxins will be locked in the office. Postings noted to be current and in compliance with guidelines. First aid kit has been placed by medications. PPE is being stored in a supply room. Disaster Drills have been conducted often and in different shifts with the last one being conducted on 7/2021. Community Care Licensing has requested the following items be corrected prior to licensure: (LPA will be revisiting facility unannounced after licensee communicates that facility is ready for a visit.) - Facility must be in good repair: facility need to have walls clean/painted, carpet needs to be repair and clean, residents bedrooms missing night stands and lamps, ceiling in the living room coming off and spots of water stain, resident's bedroom shades; outside area to have any tripping hazards. - Post the following: Calendar for plan activities, resident's personal rights, and non-discrimination notice. - Proof of quarterly disaster drill - last was 7/2021. - Request for underage resident exception - pre-assessment, LIC 602, letter from POA, letter from facility requesting underage exception with name and DOB for resident. (due on 11/19/2021) There were no deficiencies cited at this time.