Routine inspection·December 16, 2024

Licensing Program Analysts (LPAs) Kimberly Lyman and Fred Arias conducted an unannounced visit to The Pleasantview Home. The purpose of today’s visit was to conduct the annual required inspection. LPAs were allowed entry into the home and met with Administrator Mariza Oliva and explained the reason for the visit. Facility is licensed for 5 non-ambulatory residents and one bedridden. Facility has an approved hospice waiver for 5 residents and the home currently has 5 residents, with 1 resident on hospice. Administrator Mariza Oliva has an administrator certificate expiring on 05/04/2026. LPAs along with Administrator toured the facility at 12:55 PM. LPAs toured the physical plant, checked food service, facility documentation and the first aid kit. The home consists of 5 resident bedrooms, living room, dining room, and kitchen as well as 3 restrooms. Upon starting the tour, LPAs tested smoke detectors and carbon monoxide detector. The carbon monoxide detector is inoperable and four out of six smoke detectors are either missing or inoperable. Resident bedrooms had the required furniture, bed linens and closet/drawer space to accommodate each resident comfortably. At 1:10 PM, LPAs observed unsecured medications in a storage area. Resident bathrooms were checked.. Toilets and water faucets worked properly, grab bars were secure and shower was free of mold/mildew. Water temperature measured between 105 degrees F and 111.9 degrees F in all restrooms. Resident bath towels, toiletries and personal hygiene supplies were adequately stocked. Common areas were clean and clear of hazards. Auditory exit alarms were operational during today's visit. Perishable and non-perishable food supply was checked and adequately stocked at time of visit. LPAs observed sharps as well as cleaning supplies locked under the sink. Kitchen appliances were operational during today's visit. Fire extinguishers were fully charged. LPAs reviewed the infection control and emergency disaster plans and plans are complete and thorough. Facility conducts quarterly emergency drills with the last drill conducted on 10/02/2024. LPAs observed ample emergency food and water. Outside grounds were toured. Walkways around the home were clear of hazards. There are no security bars or weapons on the premises. There is ample shaded seating for residents. Continued on LIC 809-C dated 12/16-2024 First aid kit contained all required items including tweezers, scissors and thermometer. Facility conducts activities in the form of music, exercise and games. Exit gate is unlocked and operational. At 1:30 PM, LPAs reviewed five resident files and three staff files. All resident files contained required documentation including admission agreements, physician reports, resident appraisals, and physician orders for bed rails as indicated. Staff files reviewed contained required documentation including medical assessment/ TB, criminal record clearance and proof of CPR training. Three out of three staff files do not contain proof of annual required training hours. LPAs reviewed medication storage and administration. Medications are stored in a locked closet. Medications are being administered per physician order. Licensee has been asked to provide an updated LIC 500 (Personnel report), LIC 610 (Emergency Disaster Plan), and LIC 308 (Designation of Facility Responsibility) by 12/30/2024. Based on the observations made during today’s visit, deficiencies are being cited per Title 22 Division 6 of the California Code of Regulations. This report was discussed with the facility representative and a copy was provided as well as appeal rights.