Routine inspection·March 6, 2024

On today's date, Licensing Program Analyst (LPA) LPA Rosie Quiroz conducted an unannounced visit for the purpose of conducting a required Annual inspection. LPA was greeted and granted entry into the facility by Caregiver 1 (CG1). LPA Quiroz called Administrator (AD) Maureen Solanga and explained the nature of the visit. (AD) Solanga arrived to the facility on or about 4:47pm. This facility is a Residential Care Facility for the Elderly and licensed to provide services to six (6) Non-Ambulatory Residents, and has a hospice waiver for two (2) residents. There are four (4) residents in care of which (2) two residents are receiving hospice care services. There are no active COVID-19 cases in the facility at this time. Administrator Maureen Solanga has an Administrator Certificate with expiration date of 10/24/2024. LPA Rosie Quiroz along with (CG1) toured the interior and exterior of the facility. During today's inspection tour, LPA Quiroz observed three of four residents in their bedroom resting and 1 of four residents in the living-room area with staff supervision. LPA Quiroz interacted and interviewed with staff and residents during today's visit. Between 3:16pm-3:25pm while conducting inspection tour of the kitchen area, LPA Quiroz observed expired canned food and food items with expiration dates varying from 4/2022- 1/15/2024. This was verified with(CG1) and (AD) Solanga upon arrival to the facility. (SEE LIC 809-D) LPA Quiroz observed emergency water; however due to expired items observed in pantry area, facility does not have a supply of emergency food readily available for residents in care. LPA Quiroz inspected resident's bedrooms and bathrooms. Water temperatures were recorded to be between 114.7-119.4 degrees Fahrenheit. LPA Quiroz inspected resident’s bedrooms and appeared to be clean. Facility temperature in resident's bedrooms and throughout the facility was recorded to be within normal limits. LPA Quiroz observed the emergency and disaster and evacuation plan. LPA Quiroz toured the outside of the facility and observed seating and shaded area backyard for residents and visitor's enjoyment in backyard area. CONTINUED ON NEXT LIC 809-C PAGE... CONTINUED...While reviewing 4 of 4 resident records, LPA Quiroz observed R4's physician report indicating bedridden status. This was verified with (CG1) and (AD) Solanga upon arrival to the facility. (SEE LIC 809-D and LIC 421-IM) During today's visit, LPA Quiroz provided Consultation on Title 22, Infection control, Maintenance and Operation, Fire Clearance and General Food Service Requirements. Citations were issued during today’s visit and Civil Penalty was assessed. An exit interview was conducted with (AD) Solanga and a copy of this report, LIC 811-Confidential names, LIC 809-D pages, LIC 412-IM and Appeal Rights were provided to (AD) Solanga at exit.