Routine inspection·February 19, 2025

At approximately 10:20am , Licensing Program Analysts (LPAs) Elias Magdaleno and Chris Arnhold arrived unannounced to conduct a required 1-year annual inspection and were greeted by Supervisor Deirdre Villante. Facility is a Residential Care Facility for the Elderly (RCFE) with eight ( 8 ) residents in care. Facility has a Hospice waiver for two ( 2 ), with no Hospice residents currently in care, and is approved for all non-ambulatory residents. At approximately 10:45am , LPAs initiated a tour of the facility with Supervisor and observed the following: Facility is a one story home, was a comfortable temperature, and passageways were free from obstructions. Fire extinguishers were last inspected 1/27/2025 . Water temperatures measured 116.2 degrees F in room 200 and 123.4 degrees F in room 214, a discussion was had with supervisor about water temperature. LPAs observed a supply of clean linens, hygiene, incontinent care, and paper products available for residents. Residents' bedrooms were inspected and observed to have all the appropriate furnishings as outlined in Title 22 regulations. Cabinets containing cleaning supplies and other items that could pose a risk were locked. LPAs observed at least a 2-day supply of perishable food, 7-day supply of non-perishable food, and emergency water supplies. Per discussion with Supervisor, breakfast is made in facility with lunch and dinner sourced from off-site facility elsewhere on property. Food was found to be stored in a safe manner with open items covered. LPAs observed a piano, puzzles, and a movie room accessible to residents. Outdoor seating and tables are available to residents weather permitting. Internet service available, discussion had with Supervisor about acquiring a shared internet accessible device. Continued 809C... Continued from 809... At approximately 12:00pm LPAs conducted review of five (5) resident records. All required documentation present. At approximately 12:45pm LPAs conducted a review of five ( 5 ) staff records. Three (3) of five (5) staff did not have training hours complete. At approximately 1:40pm LPAs and Supervisor Deirdre Villante conducted a spot check of medication and medication records. Medication is centrally stored and locked. Gary Piner Administrator Certificate 7034473740 expires 12/01/2025 . All fees are current as of this time. LPAs and Administrator discussed facility's Infection Control Plan and Emergency Disaster plan, No new updates. Facility’s last quarterly disaster drill was conducted on 2/3/2025 . Deficiencies cited from the California Code of Regulations, Title 22, Division 6 of California Regulation and the Health and Safety Code. Appeal rights given and discussed with Supervisor. Failure to correct the deficiency and/or repeat deficiencies within a 12-month period may result in civil penalties. Updated copies of the following documents were requested for facility file and are to be submitted to CCL within 30 days of this visit: Liability Insurance LIC500- Personnel Report LIC308- Designation of Responsibility Exit interview conducted with Supervisor and a copy of this report was given.