Routine inspection·May 21, 2025

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 front desk staff after introducing himself and stating the purpose of the visit. Operations Manager Maria Constantin was notified upon arrival and joined shortly afterwards to assist with the visit. LPA reviewed the facility's resident census, staff roster and schedule as well as the Emergency and Disaster Plan and Infection Control Plan. There are 25 residents in care, eleven of which are receiving hospice care at the time of the visit. A sample of six staff records and six resident records were requested and reviewed during the visit. Postural supports are observed to be in use by a number of residents. Hospice plan of care and corresponding physician orders verified to be on file. Admission agreement is missing from one file reviewed, and three others are missing one signature or both signatures. Type B deficiency cited. Consultation provided on fire clearance requirements for bedridden residents. All staff members listed on the facility's roster form are verified to be background cleared and associated to the facility at the time of the visit. CPR training is current for all staff members reviewed. Proof of initial and annual training are kept in Relias and will be provided by staff as soon as possible for LPA review. The facility is a two-story secure building. LPA accompanied by facility staff conducted a tour of the interior and exterior of the physical plant. A total of 12 occupied units were inspected during the tour. Rooms were provided with furniture in good repair, clean linens, adequate storage space, and kept free of tripping hazards. CONTINUED ON FORM LIC809-C CONTINUED FROM FORM LIC809 Bathrooms were observed to be in good repair; and provided with grab bars and non-skid floor materials. Hot water was measured in multiple locations with measurements ranging from 117F to 126F. Multiple taps observed to provide water above 120F. Type B deficiency cited. The fire panel and sprinkler inspection reports were reviewed during the visit and did not evidence any issues with the fire safety systems at this time. Latest fire safety visit is dated September 20, 2024. Wall-mounted fire extinguishers are observed throughout the premises and appear to have received adequate maintenance per the tags attached. The facility utilizes delayed egress throughout the premises. Use of delayed egress approved by the Fire Marshall upon delivery of the fire clearance. Evacuation chairs confirmed to be in place at the top of staircases. Fire and evacuation drills are conducted monthly as evidenced by the training records provided. LPA accompanied by staff toured the kitchen and laundry areas. Facility met the minimum two day perishable and seven day non-perishable food stock requirements. Cleaning supplies, and sharp items were inaccessible to residents in care. Both levels have a med room that is verified to be locked as well as medication carts which are actively kept secure when not directly attended by staff. Both separate levels of the facility have ongoing access to a secure outdoor space with available shade and outdoor furniture. Halls and routes of egress were free of tripping hazards. Two type B 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 along with appeal rights was left at the facility.