Routine inspection·August 20, 2024

Licensing Program Analyst (LPA) Michael Tea conducted an unannounced visit. The purpose of today’s visit was to conduct the Annual Required inspection. At around 1:15 PM, LPA Tea was greeted and granted entry into the facility by Assistant Administrator (AA), Terri Joiner and explained the reason for the visit. The administrator (AD) Kerry Joiner arrived shortly to assist with the visit. The facility is licensed for 6 non-ambulatory residents with a hospice waiver for four. Currently there are six residents, of which one resident is on hospice during today's visit. Around 1:32 PM, LPA Tea reviewed six resident files and two staff files. Resident files and staff files contained all required documentation except one minor issue with dementia residents not having updated medical assessments. Licensee were able to obtain updated medical reports during today’s visit. Upon review of records, the facility is up to date with required quarterly fire drill, which was last conducted in July 5, 2024. AD Joiner’s administrator certificate is currently expired however administrator has complied with all course work and is pending renewal at this time. LPA Tea along with AD Joiner toured the facility at 2:22 PM. LPA toured the physical plant, checked food service, and the first aid kit. The facility is a single-story home that consists of 5 resident bedrooms, 1 caregiver room, 3.5 bathrooms, living room, dining room, family room, kitchen and an attached garage. LPA observed smoke detectors/carbon monoxide in common areas and bedrooms are operational. Resident bedrooms had the required furniture, bed linens and closet/drawer space to accommodate each resident comfortably. 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 106.8 F degrees and 116.2 F degrees. Resident bath towels, toiletries and personal hygiene supplies were adequately stocked at time of visit. Common areas were clean and clear of hazards, doorways were free of obstructions. First aid kit had all the required elements including bandages, tweezers, thermometer, and scissors. Kitchen was inspected. Perishable and non-perishable food supply was checked and adequately stocked at time of visit. Annual continuation on LIC809-C LPA observed sharps locked in a kitchen cabinet. LPA also observed toxin substances to be locked and inaccessible to clients in care underneath the kitchen sink. The fire extinguisher was fully charged in the garage and serviced on April 24, 2024. Kitchen appliances are operational during today's visit. LPA toured the outside grounds and there is ample seating underneath a shaded patio area in the backyard. There is one exit gate that is self-latching and operational on the left side of the house. LPA observed PPE supplies, emergency food and water stored in the garage. Facility provides activities based on their personal choice. Residents walk around the house and do some gardening in the yard. The licensee hold family events for residents in the backyard. At the time of the visit, LPA observed residents watching television and reading a book. At 2:40 PM LPA reviewed medication storage and administration. Medications are stored in a locked cabinet in the kitchen. Medications are being administered per physician order. LPA interviewed residents regarding their quality of care and spoke to staff present regarding care provided. Based on the observations made during today’s visit, no deficiencies were noted today in the areas inspected per Title 22 Division 6 of the California Code of Regulations. This report was reviewed with Administrator Kerry Joiner and a copy of this report LIC809, along with the 809-C, LIC858, LIC859, and LIC9102TV were read and provided to the facility.