Routine inspection·August 8, 2024

On this day, Licensing Program Analyst (LPA) Kevin Saborit-Guasch made an unannounced visit to the facility for the purpose of conducting a required annual Inspection. LPA was greeted and granted entry by facility caregiving staff after introducing himself and stating the purpose of the inspection. Administrator Lonnie Fischer was notified via telephone and arrived later to assist with the visit. During the inspection, LPA accompanied by facility staff conducted a tour of the physical plant and observed the following: The facility is a one-story home. There are five private bedrooms and five shared bathrooms including multiple en-suite bathrooms, in addition to the facility's common living areas. All resident bedrooms have the required furnishing, bathrooms are equipped with grab bars and slip mats. LPA observed all beds have linens and blankets. One resident not admitted on hospice is observed to have full bed rails which were substituted for half rails during the visit. No physician orders for these could be located. The backyard has a shaded area and the routes of egress are free of clutter and obstructions. There are currently five residents admitted to the facility with three residents on hospice. At the time of the visit, no granted hospice waiver was found on file. Residents are observed to be clean and appear well taken care of. Bathrooms faucets and toilets were operational. Water temperature was verified to be within the required range. LPA observed emergency disaster plan with means of exiting and emergency phone numbers listed and posted. Fire drills are not conducted quarterly. LPA observed the facility has a 2-day supply of perishables and a 7-day supply of non-perishable food as required. Smoke and carbon monoxide detectors tested operational. Two fire extinguishers present is observed to be fully charged however the proof of maintenance is dated April 2020 and outdated. Sharp items, cleaning supplies and medications were confirmed to be inaccessible throughout the physical plant. CONTINUED ON FORM LIC809-C CONTINUED FROM FROM LIC809 The medication central storage was also observed to be secure and was reviewed for accuracy during the visit. LPA reviewed five resident files along with four staff files. Multiple physician reports are observed to be dating by over a year for residents with an indication of dementia. No documentation of annual training for 2024 is present on file. Based on the observations made during today’s inspection, two type A and six type B deficiencies are being cited per Title 22 Division 6 of the California Code of Regulations. An exit interview was conducted with facility administrator who then had to leave and gave permission to caregiving staff to sign on his behalf. A copy of this report along with appeal rights was emailed to the licensee at the conclusion of the visit.