Routine inspection·June 20, 2024

Licensing Program Analysts (LPAs) Helena Rummonds and Jacky Macias arrived unannounced at approximately 9:30AM to conduct an Annual Required inspection and was greeted by staff. LPAs and staff discussed the purpose of the visit to Administrator Ric Pielstick. At approximately 9:45am, LPAs and staff initiated a tour of the facility which included resident apartments, kitchen, food storage, dining room and various common areas used by residents. Facility was a comfortable temperature and passageways were free from obstructions. Resident rooms were furnished per regulation. Water temperature in various restroom sinks accessible to residents in care were all within the range of 105 to 120 degrees F allowed per regulation. Extra hygiene products and linens were available. Cleaning supplies are locked in supply closet. Facility has at least two days of perishable and one week of non-perishable foods which appeared to be of quality, stored per regulation. There are residents with special diets needs that are being provided by the facility. Facility kitchen has a binder and posted on the wall with all resident’s names, pictures, and their needs. Food is available for residents any time of the day. There is also a daily activity schedule for residents. Upon touring the Memory care unit, LPAs observed a residents bed sheets to be wet and having an incontinence odor throughout the Memory Care unit. Medications are centrally stored in a secured room and were reviewed. Emergency food and water supplies are stored in a secured room. Personal Protective Equipment is stored in PPE closet. Fire extinguishers were last serviced September 22, 2023. Facility has combination smoke and carbon monoxide detectors as well as a sprinkler system that is serviced by an outside vendor that was last inspected on 06/12/2024. Most recent fire/disaster drill was conducted 06/20/2024. Continued on LIC809C... Continued from LIC809 Ten staff files and ten resident files were reviewed. Staff have required First Aid and CPR certificates. Training records were reviewed and staff have required training. Administrator Certificate for Administrator, Richard Pielstick (702666740) Exp 8/26/2024. Administrator to submit updates of the following documents by 05/12/2024: LIC 500 Personnel Summary Copy of Liability Insurance LIC 9020 Register of Residents Emergency Disaster Plan (If any changes) Infection Control Plan (If any changes) Deficiencies cited from the California Code of Regulations, Title 22, Division 6 of California Regulation. Failure to correct the deficiency and/or repeat deficiencies within a 12 month period may result in civil penalties. Appeal rights given. Exit interview was conducted with Administrator and a copy with given. Signature on forms confirms receipt of documents...