Non-compliance follow-up·October 20, 2022

LIcensing Program Analyst (LPA) Jill Nakagawa arrived at 1:00 PM and conducted an unannounced random required non-compliance inspection of the facility. LPA met with Executive Director Ric Pielstick. LPA toured the building and grounds with Executive Director and found the facility to be clean and in good repair. LPA did a room inspection of the Traditions/Memory Care Unit and found all the bathrooms were equipped with necessary grab bars and non-slip floors/mats. Residents were eating lunch in the dining room, with care staff and servers attending the residents with their meals. LPA reviewed 6 resident records (R1 -R6) which showed that 4 out of 6 residents' 602's were not complete, so Medical Assessments will need to be completed as stated on attached 809-D At the time of inspection Medications were stored and locked at all times. There have been no medication errors since the NCC of 6/14/2022. There were no residents with any Prohibited Conditions at the time of inspection. Resident Records were reviewed and appeared to be in order. At the time of inspection staffing in Memory Care currently has 4 care staff and 1 med tech, along with dining staff helping with meal service but not care. LPA requested Memory Care Schedule for the last 3 months. Food Service was inspected and LPA found that perishable foods were stored in covered containers, and the refrigerator and freezer were at a temperature within regulation. LPA requested proof of staff training by certified staff on food handling and storing. The following deficiency were observed (see LIC 809D) and cited from the California Code of Regulations, Title 22, Division 6, Ch. 8 of California Regulation. Failure to correct the deficiency and/or repeat deficiencies within a 12 month period may result in civil penalties. Exit interview conducted and appeal of rights provided.