Routine inspection·April 23, 2024

On today's date, Licensing Program Analysts (LPA) LPA Rosie Quiroz conducted an unannounced visit for the purpose of conducting a required Annual inspection. LPA was greeted and granted entry into the facility by House Manager (HM) Kristine Guevarra. LPA Quiroz called Licensee/Administrator (L/AD) Uldarico Almiranez and discussed purpose of today's visit. This is a Residential Care Facility for the Elderly, licensed to provide services to age range 60 and over, approved for capacity of (6) six Non-Ambulatory residents, of which 1 (one) may be bedridden and has a Hospice waiver approved for 4 hospice residents. There is currently one (1) resident receiving hospice care services. There are no active COVID-19 cases in the facility at this time. AD Uldarico Almiranez has an Administrator certificate with expiration date of April 10, 2024. AD Almiranez indicated currently in process of renewing Administrator certificate, and agreed to submit copy of renewal to Community Care Licensing upon completion. LPA along with (HM) Guevarra toured the interior and exterior of the facility. During today's inspection tour, LPA observed 3 of 6 Residents in the living room with staff supervision and 3 of 6 residents in their bedroom resting. LPA Quiroz interacted and interviewed with three caregivers and 3 of 6 residents during today's visit. LPAs inspected resident's bedrooms and bathrooms. The water temperature in resident's bathrooms were recorded to be within normal limits. LPAs inspected resident's bedrooms and appeared to be clean. Facility temperature in resident's bedrooms and throughout the facility was recorded to be within normal limits. LPAs observed the emergency and disaster and evacuation plan. Facility has supply of emergency food, water in the garage and kitchen area and PPE in the medication closet readily available for staff and residents in care. Fire extinguisher observed last serviced on March 19, 2024. LPA observed functional and operational washer and dryer in the laundry room area. The disinfectants were observed to be locked and secured. CONTINUED ON NEXT LIC 809-C PAGE... On or about 10:25am, while inspecting the kitchen area, LPA Quiroz observed the following in refrigerator area unlocked and unsecured: Ozempic injection, Basaglar injection and Novolog flex pen injection, Simbrinza eye drops and latanprost eye drops readily available for residents in care. On or about 10:36am, while inspecting garage area, LPA Quiroz observed opened door leading to garage area and observed pair of scissors and lighter readily unlocked and unsecured readily available to residents in care. This poses a potential risk to residents in care. (SEE LIC 809-D) LPA toured the outside of the facility and observed seating and shaded area in the backyard for residents and visitor's enjoyment. LPA reviewed 6 of 6 resident records and centrally stored medications and 4 of 4 personnel files. Citation issued during today's visit. During today's visit, LPA provided Consultation on Title 22 and Infection control. An exit interview was conducted with HM Kristine Guevarra, and a copy of this report, LIC 809-D page, Appeal Rights, LIC 858- Client/Resident's records review and LIC 859- Staff Records Review were provided at exit.