Routine inspection·May 6, 2025

On this day Licensing Program Analyst (LPA) Fred Arias made an unannounced visit to conduct a required annual visit. LPA was greeted and granted entry into the facility by staff and explained the reason for the visit. Facility is licensed for 15 non-ambulatory residents. Facility has an approved hospice waiver for 15 residents and the home currently has 10 residents, with 2 residents on hospice. Administrator (AD) Aurora Tecson arrived shortly to help conduct facility visit. AD provided updated liability insurance that expires on 07/06/2025. LPA along with staff toured the facility at 12:10 PM. LPA toured the physical plant, checked food service, and facility documentation. The home consists of 8 resident bedrooms, living room, dining room, and kitchen as well as 2 bathrooms on the first floor. The second floor consists of an office and two staff rooms. No residents in care are in the second floor. Resident bedrooms had the required furniture, bed linens and closet/drawer space to accommodate each resident comfortably. LPA observed all resident beds had bed rails. Resident bathrooms were checked. Toilets and water faucets worked properly, grab bars were secure and shower was free of mold/mildew. Water temperature measured between 119.3 degrees F and 119.8 degrees F in all bathrooms. Resident bath towels, toiletries and personal hygiene supplies were adequately stocked. Common areas were clean and clear of hazards. Auditory exit alarms were operational during today's visit. LPAs toured the kitchen and observed sharps locked in a cabinet during today's visit. Perishable and non-perishable food supply was checked and adequately stocked at time of visit. Kitchen appliances were operational during today's visit. Fire extinguishers were fully charged. LPA reviewed the infection control and emergency disaster plans and plans are complete and thorough. Continued on LIC809-C dated 05/06/2025. Facility conducts quarterly emergency drills with the last drill conducted on 03/25/2025. Outside grounds were toured. Walkways around the home were clear of hazards. There is shaded outdoor seating for residents. At 12:40pm one out of two exit gates leading to the street was observed to be locked. LPA observed the emergency food and water supply. At 12:50pm, LPA observed four Link cameras with audio capabilities in the common areas of the facility. LPA reviewed six resident files and four staff files. All resident files contained required documentation including admission agreements, physician reports and resident appraisals. Nine out of ten resident files did not contain physician's orders for bed rails. Staff files reviewed contained required documentation including required annual training, medical assessment/ TB, criminal record clearance and proof of CPR training. LPAs reviewed medication storage and administration. Medications are stored in a locked closet. At 3:21pm, LPA observed medication for client 7 was not given as prescribed per physician's orders. LPA was unable to test the smoke alarms as they are serviced by a third party company. Facility did not have records of the last service date. Based on the observations made during today’s visit, deficiencies are being cited per Title 22 Division 6 of the California Code of Regulations. This report was discussed with the facility representative and a copy was provided along with appeal rights.