Routine inspection·December 6, 2024

On December 6, 2024, at 8:30am, Licensing Program Analyst (LPA) Edward Kim conducted an unannounced required 1-Year annual visit using the CARE Inspection Tool. Upon arrival at the facility, LPA Kim was greeted and granted entry by staff. LPA Kim met with Executive Director (ED) Kat Farris and explained the purpose of the visit. The facility is licensed to operate for seventy-six (76) nonambulatory residents and have a hospice waiver for seven (7) residents. The facility is a single-story structure. It consists of the following: fifty-eight (58) resident bedrooms, sixty-nine (69) bathrooms, eight (8) offices, lounge area, main dining area, small dining area, private dining room, kitchen, an outdoor covered seating areas, beauty salon, meeting room, chapel, craft room, ice cream parlor, library, storage rooms, laundry room, ceramic room, waiting room, and a tower room. LPA Kim toured inside and outside of the physical plant with ED Farris. There were no bodies of water or obstructions on the premises. All rooms were inspected. Beds and bedding supplies were in good condition, adequate lighting was provided, storage for each resident’s personal belongings was observed. Bed linens, comforters, and bath towels were adequately stocked at the time of visit. The Resident’s rooms were inspected: Resident Room 8, Resident Room 16, Resident Room 18, Resident Room 19, Resident Room 33, Resident Room 38, Resident Room 39, Resident Room 46, Resident Room 49, and Resident Room 50. Bathrooms were found to be clean and operational. The water temperature measured at 116.2 degrees F to 119.3 degrees F. A comfortable temperature of 72 degrees F was maintained in the facility. LPA Kim observed the facility to be sanitary and appropriately furnished at the time of visit. Storage areas for personal hygiene, cleaning supplies, toxins, and sharps objects were stored and not accessible to residents. The kitchen was inspected and there is a two-day supply of perishable and seven-day supply of non-perishable food available and maintained properly. Emergency safety drills were last conducted on November 21, 2024, and conducted quarterly. Evaluation Report Continues on LIC 809-C Evaluation Report Continues on LIC 809-C During the visit, LPA Kim observed the facility's infection control practices, plan of operation, and screening protocols for visitors, staff, and residents. LPA observed the facility has a 30-day supply of Personal Protective Equipment (PPE). All mandated inspection control posters were posted. The smoke detectors and carbon monoxide detectors were operable. Alarm systems are tested annually by Cosco Fire Protection and last conducted their annual inspection on November 21, 2024. A working telephone (714-577-9281) remains available, and the facility have computers available in the library that can be used for video teleconference purposes. Emergency food and supplies are stored in 2 storage rooms next to the kitchen, and emergency water is stored in a storage room next to the utility room. The facility has twenty-nine (29) fire extinguishers that were charged, mounted throughout the facility, and serviced on October 9, 2024. First aid kit is maintained and contains all the necessary elements. LPA Kim conducted an audit of ten (10) resident files (R1-R10), ten (10) staff files (S1-S10), and medication and medication administration review that were all in order and complete. LPA Kim conducted one (1) staff interview and seven (7) resident interviews. No Deficiencies were cited during the time of the visit. An exit interview was conducted, and a copy of this report was provided to Executive Director Kat Farris.