Correction check·May 26, 2022

Licensing Program Analysts (LPA) Celine De Perio and Albert Marin made an unannounced plan of correction visit in this facility. LPAs spoke with Administrator Theresa Kholoma and stated the purpose of this visit. During the required annual inspection on May 9, 2022, deficiencies were observed and citations were issued per Title 22 Division 6 of the California Code of Regulations (CCR) CCR 87202(a): On May 9, 2022 LPAs observed that facility did not maintain the fire clearance approved by County Fire Department. At 11:28 AM, LPAs observed locked padlocks on both backyards exit gates. Observation verified with House Manager. This poses an immediate threat on safety of residents in care. As plan of correction, house manager directed staff to remove padlocks on both exit gates. Threat reduced. As plan of correction, facility will no longer apply padlocks on both exits. As proof of correction, Administrator will provide training on the regulation cited; and copy of the training will be provided to Community Care Licensing Division (CCLD) on or before May 23, 2022. Proof of correction received by due date. LPAs inspected backyard gates. Deficiency cleared. CCR 87705(f)(1)(2): On May 9, 2022 LPAs observed that facility did not maintain the knives, over-the-counter medication, cleaning supplies and disinfectants inaccessible to residents with dementia. LPAs observed knives in an open drawer, over-the-counter medication in resident's drawer, and cleaning supplies and disinfectants in a garage with open door. This poses an immediate threat in health and safety of residents in care. House Manager instructed staff to keep knives in locked cabinet, take over-the-counter medication out of resident's drawer, and to always close and lock garage door. Threat reduced. As proof of correction, Administrator will provide training on the regulation cited; and copy of the training will be provided to Community Care Licensing Division (CCLD) on or before May 23, 2022. Proof of correction received by due date. LPAs inspected kitchen. Deficiency cleared. Continued on page 2. CCR 87365(h)(2): On May 9, 2022, based on LPA’s observation, interview and file review, the facility failed to keep the centrally stored medication in a safe and locked place that is not accessible to residents in care, other than employees responsible for the supervision of centrally stored medication. LPAs observed a total of 33 bottles of both sealed and unsealed medication in resident #1's room. This poses an immediate threat on the health and safety of the residents in care. As proof of correction, House Manager instructed to remove all medications from resident's room. Threat reduced. Administrator will provide training to staff on regulations cited. As proof of correction, Administrator will provide training on the regulation cited; and copy of the training will be provided to Community Care Licensing Division (CCLD) on or before May 23, 2022. Proof of correction received by due date. LPAs inspected room during this visit. Deficiency cleared. CCR 87625(3): LPAs observed that facility failed to keep residents room clean and odor free from incontinence. LPAs noted a strong offending odor in a room shared by resident #2 and #3. This poses potential threat on health and safety of residents in care. As proof of correction, House Manager will ensure that room is kept clean and odor free at all times. As proof of correction, Administrator will provide training on the regulation cited; and copy of the training will be provided to Community Care Licensing Division (CCLD) on or before May 23, 2022. Proof of correction received by due date. LPAs inspected the room during this visit. Deficiency cleared. LPAs conducted a phone exit interview with the facility administrator (AD). AD granted permission for staff to sign and receive the report. LPAs left a copy of this report and letters of cleared deficiencies in the facility.