Post-licensing visit·April 18, 2023

Licensing Program Analyst (LPA) Cuadra arrived unannounced to conduct a post-licensing inspection. LPA met with Administator, Marisol Goco. The facility has residents receiving hospice services and there are residents with a diagnose of Dementia. Upon arrival LPA was screened and signed in per facility protocol. Facility is a one story building and is approved by Napa Fire Department for 44 non-ambulatory resident's room capacity of which 10 may be bedridden. LPA/staff toured building and grounds which were found to be clean and in good repair. Exits and walkways were free from obstructions. Exit alarms were working properly. LPA observed required postings. Facility had sufficient perishable and non-perishable food. LPA observed residents were participating in an exercise activity. Facility has first aid kit which was found to be appropriate during the Post-Licensing inspection. There is outdoor space for activities. LPA obtained a copy of activity calendar and weekly dated menu was also observed. All resident’s bedrooms have lighting & appropriate furnishings, and resident’s beds were outfitted with mattress pads as required by Title 22 Regulations. Carbon monoxide detectors were present throughout the facility. Fire extinguishers inspected were charged and current as of July 2022. Facility has smoke detectors and sprinklers. Fire panel was last inspected 07/2022. Last disaster drill was conducted on January 2023. Hot water temperature measured at 104.5, 106.2, 114.4 and 116.9 degrees in resident's bathrooms which is within regulation. Bathrooms had necessary grab bars and non-slip mats.Medications were centrally stored and secured. Medications inspected were in their original containers. Continues on LIC809C... Continued from LIC809... Facility uses a written medication administration record and provided a copy of their last medication audit conducted by an outside agency dated 10/22 stating the facility was found in compliance with medication storage, first aid kit, medication centrally stored, destruction records including medication refrigerator storage and controlled narcotics. Toxins were locked and secured. Facility had extra fresh linens and hygiene supplies available for residents. During today's post-licensing inspection, LPA reviewed six residents and six staff files. Residents have current medical assessments, but their needs and services care plans needs to be reviewed and signed by their responsible parties for 5 out of 6 residents. Staff records indicated that CPR/1st aid and staff have received required annual training hours. Admission agreements were updated with an addendum indicating the change of ownership. Surveillance cameras use in common areas were included in previous admission agreements. Administrator certificate for Marisol Goco # 6018647740 expires on 8/2/2024. Administrator will provide copies of the following by 4/25/2023: 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.