Routine inspection·August 30, 2024

Licensing Program Analyst (LPA) Rose Ruppert made an unannounced visit to the facility today to conduct an Annual Required Evaluation. LPA was greeted and granted entry by Staff #1. During today’s visit, LPA met with Lordele De Los Reyes, Administrator. The facility is a seven bedroom, single story building with an approved fire clearance of five non-ambulatory residents of which one may be bedridden in bedroom six and four are approved for hospice. The facility currently has a census of five residents in care. During today’s visit, LPA arrived at 8:00am and observed three residents eating breakfast. LPA toured the facility and inspected the physical plant, including but not limited to testing all smoke detectors, testing hot water temperature in four of four resident bathrooms, and testing auditory devices on all exits . The hot water temperature measured between 106.3 and 112.2 degrees Fahrenheit and all smoke detectors were operational . The fire extinguisher is charged and was serviced on August 7, 2023. The facility’s last fire drill was conducted on July 7, 2024. LPA inspected the facility food supply and observed the facility retained a minimum of two days perishable and seven days non-perishable food on hand. LPA observed medication storage and reviewed the centrally stored medications. Per review medications are being given as prescribed and the First Aid kit is complete. PUB 475 sign is not 20" X 26" regulation size. Chlorox was immediately secured underneath kitchen sink. LPA reviewed three of three staffing and fingerprint records and a complete review of resident records . LPA interviewed alert residents regarding their quality of care and spoke to staff present regarding care provided. LPA confirmed that administrator has a current administrator certificate which expires on October 6, 2025. (Continued on LIC 809-C) (Continued from LIC 809) Upon records review, two of five residents had Admissions Agreements on file. Five of five residents require updated physicians' reports due to clinical diagnosis on file. Two of five residents did not have postural supports orders. The following deficiencies are being cited per Title 22 Division 6 of the California Code of Regulations. An exit interview was conducted with Lordele De Los Reyes, Administrator and a copy of this report was given to the facility along with a copy of the LIC 9102-TV,LIC 858, LIC 859; LIC 809-D and Appeal Rights.