Routine inspection·September 25, 2024

On this day, Licensing Program Analyst (LPA) Kevin Saborit-Guasch made an unannounced visit to the facility for the purpose of conducting the Required Annual Inspection. LPA was greeted and granted entry by facility caregiving staff after introducing himself and stating the reason of the visit. Administrator Aurica Bintintan was also present and assisted with the visit. During the inspection, LPA and staff conducted a tour of the physical plant and observed the following: The facility is a one-story home with four private and one shared bedrooms in addition to two staff rooms for use by the live-in caregiving staff and administrator. There are five bathrooms throughout the facility, either accessible through the hallways or en-suite in the bedrooms. All bathrooms are observed to be equipped with grab bars and slip mats. All resident bedrooms have the required furnishings. LPA observed all beds have linen and blankets. Multiple beds are observed to be equipped with full bed rails and another one with half rails. Physician orders and hospice plans of care reviewed as well as physician order for the half rails. Consultation provided. There are currently six residents admitted to the facility, four of which is receiving hospice care. Bathrooms faucets and toilets are operational. Water temperature was measured to be within acceptable temperature range. LPA observed emergency disaster plan with means of exiting and emergency phone numbers listed and posted. Drills are conducted quarterly however they are not systematically documented. Consultation provided. LPA observed the facility has a 2-day supply of perishables and a 7-day supply of non-perishable food as required by regulations. Smoke and carbon monoxide detectors tested operational. Fire extinguisher present is fully charged and has been replaced in 2024. There is adequately shaded outside space with outdoor furniture present. There are self-latching gates on both sides of the property. The route of egress is free of obstructions. There are no bodies of water on the premises. CONTINUED ON FORM LIC809-C CONTINUED FROM FORM LIC809 Medication, cleaning products and sharp items are confirmed to be inaccessible throughout the physical plant. The medication central storage was also observed to be secure and reviewed to be accurate and up to date with the resident's prescription orders. LPA reviewed six resident files and three staff files. Two staff and one resident interviews conducted. Resident records include all necessary components. All staff members on the facility's roster are confirmed to be cleared and associated with this particular licensed location. Training records, health screenings and CPR training are on file and up to date. Training provided meets the regulatory requirements for initial and annual training. Based on observation and records reviewed, one resident receiving hospice care is observed to be and have been assessed as bedridden. The current fire clearance for the facility does not include a provision for bedridden residents. Type A citation issued. Based on the observations made during today’s inspection, one type A deficiency is being cited per Title 22 Division 6 of the California Code of Regulations. Three Advisory Notes issued along with consultations provided to the licensee. An exit interview was conducted and a copy of this report along with appeal rights was provided to a facility representative.