Routine inspection·May 8, 2024

On today's date, Licensing Program Analyst (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 Administrator (AD) Jeremias Filio. LPA met with (AD) Filio 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) residents; 1 bedridden and 5 non-ambulatory residents and has a Hospice waiver approved for 6 hospice residents. There are currently six (6) resident in care at this time, of which (1) one is receiving hospice care services. AD Jeremias Filio has an Administrator certificate with expiration date of March 10, 2024 indicating he completed the renewal February 26, 2024 and waiting to receive renewal certificate. AD Filio agreed to submit new certificate to CCLD upon receipt. LPA along with (AD) Filio toured the interior and exterior of the facility. During today's inspection tour, LPA observed 2 of 4 Residents in the living room with staff supervision and 4 of 6 residents in their bedrooms resting. LPA Quiroz interacted and interviewed with caregivers and residents during today's visit. LPA inspected resident's bedrooms and bathrooms. The water temperature in resident's bathrooms were recorded to be within normal limits. LPA inspected resident's bedrooms and appeared to be clean. Facility temperature in resident's bedrooms and throughout the facility was recorded to be 74 degrees Fahrenheit. LPA observed the emergency and disaster and evacuation plan. Fire extinguisher observed last serviced on March 2, 2024. LPA observed functional and operational washer and dryer in the garage area. Medications, sharps and disinfectants were observed to be locked and secured. LPA toured the outside of the facility and observed seating and shaded area in the backyard for residents and visitor's enjoyment. CONTINUED ON NEXT LIC 809-C PAGE... CONTINUED...On or about 3:35pm while inspecting the kitchen area, LPA Quiroz observed pineapple with fuzzy green in color on pineapple in container without a cover appearing to look like mold, unlabeled food in zip lock bags with no dates, multiple food items not labeled without covers and the following expired food with expiration dates ranging between February 3, 2023- March 3, 2024: ranch dressing, tartar sauce, lasagna, pears, apples, melon, activia yogurts and snack vanilla and chocolate puddings. AD Filio verified observations and discarded expired food during today’s visit indicating “Tomorrow is grocery day.” (SEE LIC 809-D) Facility has supply of emergency food, limited water and PPE in the garage area readily available for staff and residents in care. LPA verified that fire/disaster drills are conducted at least quarterly. The last fire drill was conducted on December 12, 2023. LPA reviewed 6 of 6 resident records and 6 of 7 personnel files. Citations issued during today's visit. During today's visit, LPA provided Consultation on Title 22 and Infection control. An exit interview was conducted with (AD) Jeremias Filio, and a copy of this report, LIC 809-D pages and Appeal Rights were provided at exit.