Routine inspection·June 23, 2023

On 6/23/2023, Licensing Program Analyst (LPA) Janette Romero conducted an unannounced annual required visit to the facility at 10:00 a.m. LPA was greeted and granted entry by Caregiver Noel Gonzales who was informed of the purpose of the visit. During the visit, there was three (3) residents, and two (2) staff present. The facility is made up of a one-story home with four (4) resident bedrooms, two (2) resident bathrooms, family room, dining area, kitchen, and an attached garage. LPA conducted a tour of the interior and exterior, and reviewed some facility documents. LPA observed the following: Bedrooms : Client bedrooms were each furnished with a bed, chair, closet, clothing storage and lighting. Bathrooms : Both bathrooms have a working toilet, wash basin, and were equipped with a grab bar and non-slip mats in the shower. The facility has clean towels, blankets, and linen, available in different colors for each client. Kitchen : LPA observed a sufficient supply of dishes, glasses, utensils, pots, and pans. The stove is operational. Refrigerator and freezer were in working condition. LPA observed sufficient perishable and non-perishable food available for the residents. Laundry : Laundry area had a washer and dryer. Continued on LIC809-C.. Laundry : Laundry area had a washer and dryer. Centrally Stored Medications: LPA observed a first aid kit with required components. Client medications are secured in a locked kitchen cabinet. Living/Family room : The family room had a working television. Let-Us-No poster, Long Term Care Ombudsman information, emergency phone numbers, and facility sketch were posted in living room area and entrance hallway. Yard/Outside Ar ea: A brick wall secured the entire backyard. All outdoor pathways were free of obstructions. There were no firearms or ammunition observed at the facility, and LPA was informed the facility will not store firearms or ammunition on the premises. LPA observed sharps, knives, disinfectants, and cleaning solutions unsecured and accessible to residents in care. Caregiver Gonzales stated assistance with medication was provided to residents for the past three days (6/20-23/2023), but a review of the Medication Administration Record did not document so. Administrator possessed the personnel file cabinet key on their person; therefore, LPA was unable to review personnel records. As a result, LPA issued a total of four (4) deficiencies faulting the facility. An exit interview was conducted, and a copy of this report was reviewed and provided to facility Caregiver Gonzales along with an LIC809-D and Appeals Rights.