Routine inspection·January 22, 2025

Licensing Program Analyst (LPA) Nancy Guillen and Licensing Program Manager Sheila Santos made an unannounced visit for the purpose of conducting a required annual Inspection. LPAs were greeted and granted entry by care provider Markjaydar Romuar after explaining the purpose of the visit. Administrator (AD) Erleen B. Rinehart was present at the facility and assisted with the inspection. LPA observed the Administrator Certificate expired on September 14, 2024, however LPA verified the application was submitted and received on November 10,2024 for renewal. This is a Residential Care Facility for the Elderly (RCFE) licensed to six non-ambulatory residents, of which one may be bedridden, with a hospice waiver for two. The facility is a one-story home with five resident bedrooms, one staff bedroom, two bathrooms, and an attached garage. During the inspection, LPA and AD conducted a tour of the inside and outside of the facility, common areas, resident rooms, kitchen, garage and observed the following: LPA observed residents watching television in the living room and having breakfast. LPA observed four residents in care and three staff present. LPA observed the See Something Say Something Poster (PUB 475) mounted on the wall by the entryway. All resident bedrooms had the required furnishings however R3 had a half bed rail with no doctor’s order present at the time of visit; a Deficiency was cited on today’s date. LPA observed all resident beds had linens and blankets with additional linens stored in vacant bedrooms. LPA observed bathrooms were clean and equipped with grab bars and non skid floor mats. LPA observed all windows were appropriately screened. Bathrooms were observed to be free of debris and mildew, faucets and toilets were operational. Water temperature tested between 105.9 and 113.1 degrees Fahrenheit. LPA toured the outside of the facility and observed outdoor passageways were not free of obstruction and hazards; a Deficiency was cited on today’s date. LPA observed the backyard had a shaded sitting area with furniture for resident use. Continued on LIC809-C LPA observed the facility had a 2-day supply of perishables and a 7-day supply of non-perishable food as required by regulations. Smoke detectors were tested operational, however the carbon monoxide detector was not functioning; a Deficiency was cited on today’s date. Two fire extinguishers were observed to be fully charged and located in the kitchen and living room. Electric stove, microwave, washer, and dryer were all inspected and observed to be operable. The garage is used for storage and is kept locked and inaccessible to residents. Toxic chemicals, cleaning solutions, and disinfectants were not observed to be locked and inaccessible to residents in the R3 bedroom and unlocked staff bedroom; a Deficiency was cited on today’s date. LPA observed knives stored with bleach under the kitchen sink; a Deficiency was cited on today’s date. LPA observed the First Aid Kit had all the required components. Facility was unable to provide Disaster Drill Log at the time of visit. Medication cabinet was observed to be locked and centrally stored by the entryway. During medication review, medication was observed to be transferred to a separate container and prepared 24 hours in advance for all residents; a Deficiency was cited on today’s visit. LPA observed three medications total for R1, R2 and R3 were still listed on the centrally stored medication log with medication still present at the facility. AD was unable to provide updated documentation of discontinued medications; a Deficiency was cited on today’s date. LPA began review of the records. LPA reviewed four resident records. Two out of four residents did not have a Physicians Report at the facility; a Deficiency was cited on today’s date. Two out of four residents did not have an Admissions Agreement present at the facility (R1 and R3); a Deficiency was cited on today’s date. LPA was unable to review employee records. Staff records were not present at the facility for any of the staff members to review during the inspection; a Deficiency was cited on today’s date. Based on today’s inspection, deficiencies are being cited per Title 22 Division 6 of the California Code of Regulations. An exit interview was conducted, and a copy of this report and appeal rights was left at the facility.