Routine inspection·February 23, 2022

Licensing Program Analyst (LPA) Patricia Velazquez conducted an unannounced visit to Jasmin's Care Home. The purpose of today's visit was to conduct a Required 1 Year inspection. LPA Velazquez was allowed entry into the facility and met with Caregiver Laura Perdomo. Administrator (AD) Manuel Perez arrived shortly after LPA's arrival. The facility is licensed for 6 non-ambulatory residents. There are currently 5 residents living in the facility. The last emergency disaster drill was conducted on April 3, 2021. At 2:53 PM LPA Velazquez conducted a tour of the physical plant along with AD Perez. The 1 story home consists of 4 resident bedrooms with 2 bathrooms. There are no staff bedrooms as AD Perez indicated he employs awake staff at night from 10:00 PM to 7:00 AM. The facility also has a living room, dining area, and kitchen. LPA and AD observed 4 bottles of medications were stored on top of a cabinet in the dining room easily accessible to residents. Two of the 4 bottles had prescription Amlodipine Besylate belonging to a resident which AD verified. At LPA's direction AD immediately removed the medications and locked them in the medication cabinet. The 5 residents in the facility appeared well-groomed and well cared-for. The resident bedrooms had the required furnishings, bed linens, and closet/drawer space to accommodate each resident comfortably. LPA Velazquez observed a postural support bar on one of the resident beds. AD Perez indicated he did not have a written physician's order for the postural support bar. LPA and AD observed an exit door in a resident's room did not have an auditory alarm and the facility has residents with Dementia. AD verified the sliding glass door did not have an auditory alarm pursuant to Title 22 regulation. The sliding glass in the living room also had an inoperable auditory alarm which AD verified. Resident bath towels and personal hygiene supplies were adequately stocked. Resident bathrooms were checked. Toilets and water faucets worked properly, grab bars were secure, showers were free of mold/mildew and a non-skid surface or mat was in place. LPA Velazquez tested the hot water temperature in the resident bathrooms and the temperature measured at 109.0 degrees Fahrenheit in the first bathroom and at 115.3 degrees Fahrenheit in the left sink and at 114.0 degrees Fahrenheit in the right sink of the second bathroom. LPA Velazquez inspected the kitchen along with AD Perez. LPA and AD observed the right front burner of the electric stove was inoperable which AD verified. Perishable and non-perishable food supply was checked and adequately stocked at the time of the visit. The fire extinguisher was fully charged. The smoke and carbon monoxide detectors were tested and found to be operational. Toxins and sharps were locked and inaccessible to residents. First aid kit was checked and found to be in order. The facility did have a First Aid guide dated 1989 and LPA Velazquez advised AD Perez to obtain an updated First Aid manual. LPA Velazquez along with AD Perez toured the outside grounds and observed a jacuzzi that was surrounded by a locked gate. LPA and AD observed the jacuzzi had standing water which AD indicated was from the recent rains. AD indicated he would empty out the jacuzzi by tomorrow. There was shading and sufficient seating for residents. LPA and AD also observed the umbrella that provides shading had a large tear which AD verified. AD indicated he had already order another umbrella and will email LPA a copy of the receipt by tomorrow. LPA and AD also observed broken wooden fencing and a worn wooden bench. AD indicated he would remove the wooden bench and repair the wooden gate enclosure. AD indicated he an insurance claim that is pending. There was also a large rusted metal pole with rusted screws protruding from the pole which AD verified. Walkways around the home were clear of hazards and the exit gates were operational. There were no security bars or weapons on the premises. No resident or staff files were reviewed at the time of this visit but LPA did verify 2 of the 5 residents in the facility were diagnosed with Dementia which AD verified. LPA Velazquez informed AD Perez to ensure a written physician's order for bed rails is present in a resident's file pursuant to Title 22 Regulation Section 87608 Postural Supports Deficiencies cited under California Code of Regulations Title 22, Division 6, Chapter 8. An exit interview was conducted with Administrator Manuel Perez and a copy of this report along with the appeal rights and a copy of the LIC 9098 were provided at the time of this visit.