Routine inspection·September 19, 2022

On 09/19/2022, Licensing Program Analyst (LPA) Jessica Cho conducted an unannounced visit to Care Celine. The purpose of today's visit was to conduct a Required 1 Year focusing primarily on the Infection Control. At 11:30am, LPA Cho was greeted and allowed entry by Staff #1 (S1). Per the Facility Personnel Report Summary, S1 was not on the roster. S1 indicated that S1 was shadowing for training purposes. S1 informed Staff Remedios Manuel David who then greeted LPA and completed the Coronavirus 2019 (COVID-19) screening procedure. As of today, there are no active COVID-19 cases. Facility screens and documents temperatures for visitors on a sign in sheet. LPA observed the required COVID-19 precautionary signs posted throughout the facility. The Complaint Poster (PUB475) met the Department's size regulation. The facility is licensed for six non-ambulatory residents and has a hospice waiver for six. There are currently five residents living in the facility of which five are receiving hospice care. The Administrator's Certificate for Cherry Aguila expires on 11/11/2022. Around 11:43am, LPA Cho conducted a tour of the physical plant. Administrator (Admin) Cherry Aguila was returning from a grocery trip and arrived at the facility around 11:50am. LPA Cho immediately discussed the absence of S1's criminal record clearance. Admin was consulted the importance of having S1's fingerprint cleared prior to employment. Per Staff #2 (S2), S1 began shadowing on 09/19/2022 at 6:30am. At 11:56am, LPA observed S1 leaving the facility under the Admin's instruction. LPA reinitiated the tour with Admin Aguila. The two story home consists of five resident bedrooms and two resident bathrooms. There are two staff bedrooms on the second floor and one staff bathroom. The facility also has a living room, dining area, receiving area, kitchen, and an attached two car garage with a laundry area. The resident bedrooms had the required furnishings, 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, showers were free of mold/mildew, and non-skid mats were in place. Resident bath towels and personal hygiene supplies were adequately stocked including paper towels and hand soaps. LPA observed hand washing signs in all bathrooms. LPA tested the hot water temperature in the resident bathrooms and the temperature measured at 122.3 degrees Fahrenheit in the Bathroom #1 and 122.5 degrees Fahrenheit in Bathroom #2. The water temperature was readjusted during the visit. LPA Cho inspected the kitchen along with Admin. Perishable and non-perishable food supplies were checked and adequately stocked at the time of the visit. The two fire extinguishers were charged and inspected on 07/08/2021. Admin stated two fire extinguishers will be purchased. The smoke/carbon monoxide detectors and auditory devices were tested and operational except the smoke detector on the second floor hallway as it was missing a cover. Medications, toxins, and sharps were locked and inaccessible to the residents. LPA Cho toured the outside grounds with the Admin and observed a three tier fountain with small amount of water. There was a locked shed that stored cleaning solutions. There was shading and sufficient seating for residents. Walkways around the home were clear of hazards, and two out of three exit gates were self-closing and self-latching. One out of three exit gates was missing a latch and did not close properly. There were no security bars or weapons on the premises. LPA Cho reviewed the Emergency and Disaster Plan for and Residential Care Facilities for the Elderly (LIC610E). Facility has back-up emergency food and water supply. The First Aid Kit met all the required components except a first aid manual, and the facility had sufficient PPEs. LPA consulted the following: to repair the side gate latch and smoke detector on the second floor, to install an auditory device on the exit door in the backyard, and to obtain two fire extinguishers and a current edition of a first aid manual. LPA Cho reminded the importance of staying abreast with CCLD's COVID-19 guidance by reviewing and printing the Provider Information Notices (PINs) as well as by attending the CCLD Informational Calls. The PINs can be accessed at: www.ccld.ca.gov . Based on the observations made during today's visit, a deficiency is cited in this review as per Title 22 Division 6 of the California Code of Regulations, therefore an immediate civil penalty is assessed. Advisory Notes (LIC9102) were issued during the visit. An exit interview was conducted with Administrator Cherry Aguila, and a copy of this report (LIC809, LIC809-C, LIC809-D, Civil Penalty Assessment LIC421, LIC9102s, and the appeal rights) were provided.