Routine inspection·September 20, 2022

On 09/20/2022, Licensing Program Analyst (LPA) Jessica Cho conducted an unannounced visit to Family Care- Buckboard Home. The purpose of today's visit was to conduct a Required 1 Year focusing primarily on the Infection Control. At 9:44am, LPA Cho was greeted and allowed entry by Care Staff Gloria Sabido and completed the Coronavirus 2019 (COVID-19) screening procedure. Care staff Sabido contacted and informed Licensee Russel Venanzi of LPA's arrival. Care Staff Rubie Mae Saban and Staff 2 (S2) were also present at the facility today. Staff 1 (S1) was fingerprint cleared but was not associated to this facility. Staff 2 (S2) did not have a Criminal Background Clearance. Per interviews of Staff 3 (S3) and Licensee, S2 was visiting and assisting with chores. S2 left the facility around 10:00am. As of today, there are no active COVID-19 cases. Per Care Staff Sabido, facility does not screen and document temperatures for visitors on a sign in sheet. LPA observed the required COVID-19 precautionary signs throughout the facility. The facility did not have the Complaint Poster (PUB475). The facility is licensed for six non-ambulatory residents and has a hospice waiver for two. There are currently five residents living in the facility of which one is receiving hospice care. At 10:05am, LPA Cho conducted a tour of the physical plant with Care Staff Sabido. The single-story home consists of five resident bedrooms and two resident bathrooms. There is one staff bedroom. The facility also has a living room, dining area, office area, kitchen, laundry room, and an attached two car garage. The resident bedrooms had the required furnishings, bed linens, and closet/drawer space to accommodate each resident comfortably. Resident bathrooms were checked. Toilets and water faucets worked properly, grab bars were secure, showers were free of mold/mildew, and non-skid mats were in place. Resident bath towels and personal hygiene supplies were adequately stocked including paper towels and hand soaps. LPA observed hand washing signs in both bathrooms. LPA tested the hot water temperature in the resident bathrooms and the temperature measured at 116.0 degrees Fahrenheit in the Bathroom #1 and 116.7 degrees Fahrenheit in Bathroom #2. LPA Cho inspected the kitchen along with Care Staff Sabido. Perishable and non-perishable food supplies were checked and adequately stocked at the time of the visit. The fire extinguisher was charged. The smoke/carbon monoxide detectors and auditory devices were tested and operational. Medications and sharps were locked and inaccessible to the residents. Three bottles of cleaning solutions and one disinfectant were observed on the floor in the laundry room and were immediately removed by Licensee Ginger. LPA Cho toured the outside grounds with Care Staff Sabido. There was a shed that stored furniture. There was shading and sufficient seating for residents. Walkways around the home were clear of hazards, and the exit gate was self-closing and self-latching. Facility has back-up emergency food and water supply. The First Aid Kit met all the required components except a first aid manual, and the facility had additional supply of PPEs. At 10:55am, LPA Cho spoke to Licensee Russell Venanzi via a telephone call, and Licensee Ginger Venanzi arrived shortly at 10:59am. LPA consulted the following with Licensee Ginger: to take temperatures of all visitors prior to entry, to ensure cleaning supplies and disinfectants are secured, to ensure individuals are associated and fingerprint cleared prior to volunteering in a licensed facility, to obtain the Complaint Poster (PUB475) and the first aid manual. LPA Cho reminded the importance of staying abreast with CCLD's COVID-19 guidance by reviewing and printing the Provider Information Notices (PINs) as well as by attending the CCLD Informational Calls. The PINs can be accessed at: www.ccld.ca.gov . Licensee Ginger Venanzi left the facility around 12:50pm and understands the above-mentioned, and authorized Care Staff Gloria Sabido to sign the report. Based on the observations made during today's visit, deficiencies are cited in this review as per Title 22 Division 6 of the California Code of Regulations, therefore an immediate civil penalty is assessed. Advisory Notes (LIC9102s) were issued during the visit. The exit interview was conducted with Care Staff Gloria Sabido, and a copy of this report (LIC809, LIC809-C, LIC809-D, LIC421, LIC9102s, and the appeal rights) were provided.