Post-licensing visit·December 13, 2022

Licensing Program Analyst (LPA) Sean Haddad conducted this unannounced inspection for the purpose of conducting a post licensing inspection. LPA met with Staff #1 (S1) Rosalba Maldonado, discussed the purpose of the inspection, and toured the facility. Facility Manager (FM) Wendy Cruz Andrade arrived during the inspection. Administrator (AD) Lupe Harvey appeared via telephone. LPA provided a copy of Entrance Checklist Residential Care Facilities for the Elderly (LIC9242). During the inspection, LPA and FM observed the following: Structure. This is a small commercial facility. Facility is a 13-bedroom, 5-bathroom, multi-building small commercial facility with detached garages that are being used for storage. There is a large back yard with a patio cover for the residents. Facility telephone number is (714) 733-7518. Resident Bedrooms. The 13 resident bedrooms are spacious and will easily accommodate the residents’ furnishings. Lamps, chairs, linens, and storage for each resident bedroom inspected. Staff Bedrooms. There are no staff bedrooms. Bathrooms. Bathrooms were clean, faucets and toilets were operational. Water temperature: tested between 106.7 to 117 F degrees. Linens & Hygiene Supplies. New linens and fully stocked linen closets were observed. Emergency Phone Numbers, Exit Plan & Menu: Reviewed. Food Service. 2 days perishable and 7 days nonperishable food supply reviewed. Carbon Monoxide, Smoke Detectors, Fire Extinguisher were observed, including the smoke detectors/carbon monoxide detectors. Appliances. Stove burners, microwave, washer, and dryer inspected. Knives: observed locked in the kitchen. Toxins: observed locked in closets. Medication cabinet is locked in the locked medication room. First-Aid Kit & Activity Supplies: observed and available. Resident & Staff Files. LPA reviewed resident and staff files. Fire clearance was approved by Fullerton Fire Department Inspector Peggy Castenada on 06/09/2022. Backyard. Backyard exit gate is operational and kept locked. Backyard has shaded area for outdoor activities and sufficient seating for residents. During the inspection, LPA observed there were 4 staff present, wearing PPE. LPA observed 17 residents were present. LPA conducted health and safety checks on the residents, confirmed the residents were doing well, and observed no health and safety issues. LPA observed COVID+ residents isolated in isolation rooms. LPA inspected common areas, resident rooms, kitchen, and garage and observed they were clean and organized, and found no health and safety issues. LPA observed the facility has a 2-day supply of perishables and a 7-day supply of non-perishable food is available as required by regulations. LPA observed hallways and walkways were free of obstruction. During the inspection, LPA and FM reviewed 5 staff files and 5 resident files and observed the following: 4 out of 5 staff files reviewed did not contain documentation of staff training; 4 out of 5 resident files reviewed did not contain a current appraisal. Based on the observations made during today’s inspection, deficiencies are being cited per Title 22 Division 6 of the California Code of Regulations. See LIC809D. An exit interview was conducted and a copy of this report and appeal rights was discussed with and provided to facility representative.