Routine inspection (multi-day)·July 18, 2023

Licensing Program Analyst (LPA) Alviso conducted a continued Annual visit, on 7/18/2023 at approximately 10:15am, and met with Health & Wellness Director(HWD) Rafael Daatio. The HWD contacted the Administrator Minerva Villegas. The Administrator would arrive within an hour after being contacted. Hospice care waiver approved for ten(10) residents. Facility has an approved dementia plan of operation. Facility has a required Infection Control Plan, which is part of the facility's plan of operation. Fire clearance approval is for 46 nonambulatory residents, of which 10 may be bedridden. All ten(10) smoke alarms were serviced and tagged as required- expires 5/4/24. LPA toured the facility with the HWD. Hot water was checked at 109.8F., which is within regulation. Facility was observed to be at a comfortable temperature with portable air conditioners and fans throughout the facility during the inspection. LPA observed exits free from obstruction. LPA observed residents in the large dining area watching tv, and others at a large table participating in an activity with the Activities Director. Medications were locked up, and inaccessible to residents in care. All medications were stored appropriately within State and Federal Laws during the inspection. All toxins/cleaners are stored and locked up making them inaccessible to residents' in care. The facility had a sufficient supply of food. Facility had a sufficient supply of paper products, soap, hygiene supplies, and personal protective equipment(PPE) supply. Continued on LIC809C... The LPA reviewed five(5) resident files. All files were complete. The LPA reviewed five(5) staff files, including training. All staff have required criminal record clearance. All direct care staff have current First Aid, and CPR as required. The LPA observed during the tour of the facility that there were approximately five(5)resident bedrooms, and shared bathrooms, that smelled strongly of urine. The residents that occupy the rooms are incontinent. There was also a toilet with feces left in it which left the whole room smelling of feces; The resident of this room is incontinent, uses a wheelchair, and needs to be assisted with toileting, cleaning and changing as needed. There was another room that was vacant but had a dirty diaper in a cabinet. This deficiency will be cited, 87625(b)(3) Managed Incontinence - The licensee shall be permitted to accept or retain a resident who has a manageable bowel and/or bladder incontinence condition.the licensee shall be responsible for the following: Ensuring that incontinent residents are kept clean and dry and that the facility remains free of odors from incontinence, see LIC809D. The LPA observed that there were approximately five(5)resident bedrooms, and shared bathrooms, that smelled strongly of urine. Toilets were found to have old caulking around the bottom of the toilet(s) that was peeling off, stained yellow and brown, and in some areas the caulking was missing. This deficiency will be cited, 87303(a)(1) Maintenance and Operation The facility shall be clean, safe, sanitary and in good repair at all times. Maintenance shall include provision of maintenance services and procedures for the safety and well-being of residents, employees and visitors. Floor surfaces in bath, laundry and kitchen areas shall be maintained in a clean, sanitary, and odorless condition, see LIC809D. The LPA observed that resident bathrooms had no paper towels available, and there were no paper towels in the paper towel machine in each restroom. LPA was told by staff (S2) that they don't put any paper towels in the restrooms and just hang a towel up on the bathroom towel bar for residents use. Continued on LIC809C Based on LPA's observation of no paper towels in restrooms checked. The bathrooms are not private but are to be used by residents in rooms that are on each side of the shared bathroom, jack and jill type. HWD stated to the LPA that facility doesn’t put any paper towels in the restrooms and just will hang a towel up in the bathroom for residents use. LPA didn't observe any towels in the bathrooms. Due to physical arrangements of the facility and/or the habits or condition of others in the facility, towels may be used by more than one resident, common towels are prohibited. A resident's bed was checked and when sheets were pulled back the bottom of the sheet had dirt and garbage all in it. This deficiency will be cited, 87307(a)(3)(C)Personal Accommodations and Services -The quantity shall be sufficient to permit changing at least once per week or more often when indicated to ensure that clean linen is in use by residents at all times. The linen shall be in good repair. The use of common wash cloths and towels shall be prohibited, see LIC809D. Administrator will provide copies of the following by 8/18/2023: LIC 308 Designated of facility responsibility, LIC 500 Personnel Summary, LIC 610 Emergency Disaster Plan (if there are any changes), LIC 9020 Register of Facility Client’s/Resident’s, Copy of Administrator Certificate, Copy of Certificate of Liability Insurance 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. Exit interview conducted with Administrator and appeal of rights provided.