Routine inspection·September 11, 2024

On September 11, 2024 at 8:00AM, 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 met with Maintenance Coordinator (MC) Louie Placencia. MC Placencia called Executive Director (ED) Tyler Hawk and ED Hawk stated they would arrive to join the physical tour. LPA Kim explained to MC Placencia and ED Hawk the purpose of the visit. ED Hawk could not remain for the entire visit and Business Officer Coordinator (BOC) Cristine Taylor would sign at the end of the visit. The facility is licensed to operate for eighty-three (83) non-ambulatory, of which ten (10) may be bedridden, and have a hospice waiver for fifteen (15) residents. Facility is approved for delayed egress. The facility is a two story structure, which consists of the following: seventy-eight (78) resident bedrooms, eight (8) office rooms, eighty-four (84) bathrooms, waiting area, casino room, bistro area, activity room, cinema room, dining room, hair salon room, gym, kitchen, underground parking garage, and outdoor covered patio area. LPA Kim toured indoor and outdoor of the physical plant with MC Placencia. ED Hawk joined the tour around 9:30am. There are 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, refrigerator, storage for each resident’s personal belongings was observed. Bed linens, comforters, and bath towels were adequately stocked at the time of visit. The following bedrooms were inspected: Resident Room 101, Resident Room 105, Resident Room 116, Resident Room 117, Resident Room 202, Resident Room 217, Resident Room 219, Resident Room 223, and Resident Room 247. Bathrooms were found to be within Title 22 regulations and were clean and operational. The water temperature measured between 105.0 degrees F and 118.7 degrees F. A comfortable temperature of 76 degrees F was maintained in the facility. Evaluation Report Continues on LIC 809-C Due to technical error with the wrong signature date for LPA, this report was amended with the correct signature date. During the visit, LPA Kim observed the facility's infection control practices. LPA observed the facility has a 30-day supply of Personal Protective Equipment (PPE). 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 food, Emergency water, and Emergency supplies are stored in the storage room in the parking garage. A working telephone (714) 693-5368 remains available. LPA Kim reviewed the facility’s plan of operation, emergency and disaster plan, and fire/safety drill log. The facility last conducted a Fire/Safety Drill on August 14, 2024. The facility has twenty-six (26) fire extinguishers that are charged and they were all serviced on October 25, 2023, smoke detectors, and carbon monoxide detectors were operable. First Aid was maintained and contained all the necessary elements. LPA Kim conducted an audit of nine (9) resident files (R1-R8), ten (10) staff files (S1-S10), and medication and medication administration record were all in order and complete. LPA conducted nine (9) staff interviews. No deficiencies were cited during this visit. An exit interview was conducted, and a copy of this report was provided to Business Office Coordinator Cristine Taylor.