Routine inspection·May 29, 2024

Licensing Program Analyst (LPA) Claudia Gutierrez made an unannounced visit for the purpose of conducting a Required/Annual Inspection. LPA was greeted and granted entry by Licensee Carmen Nicholas and explained the purpose of the inspection. During the inspection LPA and Licensee conducted a tour of the inside and outside of the facility, common areas, resident rooms, kitchen, garage and observed the following: This is a one-story home with five resident bedrooms, two bathrooms, and attached two-car garage. All resident bedrooms had the required furnishings, however, in bedroom of Resident 1 (R1), LPA observed and obtained a picture of a 32 ounce plastic urinal container containing R1’s urine, being stored without a lid in R1's room; a Deficiency was cited on today’s date. LPA observed all resident beds had linens and blankets. The back yard has a shaded sitting area. LPA observed residents resting in their respective bedrooms. Bathrooms were observed to be free of debris and mildew, faucets and toilets were operational. Water temperature tested at 114.8 degrees Fahrenheit. LPA observed emergency disaster plan with means of exiting and emergency phone numbers listed and posted. LPA observed the facility has a 2-day supply of perishables and a 7-day supply of non-perishable food as required by regulations. Smoke detectors and carbon monoxide detectors tested operational. Gas stove, microwave, washer, and dryer were all inspected and observed to be operable. Sharps were observed locked in a kitchen drawer. All and any toxic chemicals, cleaning solutions, laundry toxins and disinfectants are inaccessible to residents. Medication cabinet was observed to be locked. Administrator (AD) Isaiah Tashiro arrived at 11:00 a.m. to assist with the inspection. LPA reviewed five resident files and three staff files. Three out of five resident files did not have a completed appraisal dated in the last twelve months; a Deficiency was cited on today’s date. (Cont. LIC809-C) Staff files did not contain any documentation for initial 6 hours of hands-on required medication shadowing training. AD stated training was conducted upon hire but was not originally documented. Staff file review indicated 20 hours of annual training has been completed, however, did not contain eight hours of dementia care training, and four hours of which shall be specific to postural supports, restricted health, and hospice; two additional Deficiencies were cited on today’s date. LPA interviewed three residents and two staff. Based on the observations made during today’s inspection, deficiencies are being cited per Title 22 Division 6 of the California Code of Regulations. An exit interview was conducted, and a copy of this report was left at the facility.