Routine inspection·September 16, 2024

Licensing Program Analyst (LPA) Alvaro Ramirez, Jr. conducted an unannounced visit for the Required 1 Year Inspection. LPA explained the purpose of today’s visit, and was greeted and granted entry by Caregiver Norkisa Baladec. Administrator (AD) Frank Mangisi arrived shortly after. For today’s visit, LPA observed a total of six residents in care and two staff members on duty. LPA Ramirez toured the interior and exterior portions of the facility with caregiver Baladec. The facility is a single level structure and is licensed for two ambulatory residents and four non-ambulatory residents, of which six may be on hospice and zero bedridden. There are a total of seven bedrooms, of which six are resident bedrooms, and one private bedroom for staff. During the tour LPA did not observe the 20"x26" complaint poster (PUB 475).LPA Ramirez toured each bedroom in the facility and observed that bedrooms were provided with furniture in good repair, clean linens, adequate storage space, and kept free of tripping hazards. Smoke and carbon monoxide detector and auditory exit alarms were tested and operational. There are a total of four restrooms. Restrooms were observed to be in good repair, toilets were operational, and grab bars and non-skid floor mats were provided. Water temperature tested between 105.2-107.4 degrees Fahrenheit. Facility met the minimum two-day perishable and seven-day non-perishable food supplies. Sharp items and knives were locked and inaccessible to residents in care. Fire extinguisher was charged and located by the living room. CONTINUED ON LIC809-C... LPA observed the emergency disaster and evacuation plan which is located by the entryway. Facility had back-up emergency food. Licensee was reminded to have additional emergency water supply. LPA observed that First Aid Kit had all the required components. LPA observed that medications and toxins were locked and inaccessible to residents in care. For the exterior portion, LPA Ramirez observed a shaded area, patio furniture, and the grounds were free of any hazards. There are two gates in the backyard, which both are self-closing and self-latching. No bodies of water were observed. During today's visit LPA observed residents watching television shows. LPA reviewed six resident files and two staff files. LPA observed that two of six resident records did not have a pre-admission appraisal and/or the pre-admission appraisal was blank; a Deficiency was issued today. LPA observed that two of two staff have an expired cardiopulmonary resuscitation (CPR) card; a Deficiency was issued today. LPA interviewed residents and staff present. For today's visit deficiencies were issued per Title 22 Division 6 of the California Code of Regulations. An exit interview was conducted with AD Mangisi. A copy of this report was provided at the time of exit.