Routine inspection·December 27, 2023

Licensing Program Analyst (LPA) Janira Arreola conducted a required annual visit. LPA was greeted and was granted entry and met with Facility respresentative, Michael Anisimov, who was informed of the purpose of the visit. At time of visit there were (5) residents and one (32) staff present. The facility is a one story home with (5) bedrooms and (2) bathrooms with attached garage. The facility does not have a pool or fire arms. The facility is residential care facility for the elderly serving residents ages 60 and above. LPA conducted a tour of the interior and exterior, reviewed facility documents and conducted interviews. LPA observed the following: Infection Control: LPA observed the hand washing stations in the facility restrooms and kitchen had hand hygiene supplies. LPA observed PPE equipment and cleaning supplies to do regular cleaning of the facility. Physical Plant: Physical plant was observed. The facility's indoor and outdoor area was observed to be free of hazards. The sharp and dangerous objects were observed to be locked and inaccessible to clients. The smoke and carbon monoxide detectors were operational. Food Service: LPA observed facility kitchen had the ability to prepare food in clean environment and possessed equipment in good working condition. LPA observed the facility met the required 2-day supply of perishable and 7-day supply of non-perishable foods. Record Review and Resident/Staff Files: S1's staff file was unable to be reviewed for staff training, the deficiency was cited and plan of correction with the staff. The criminal record clearance was able to be verified for S1 and staff present. Health Related Services/ Incidental Medical Services: All client medication was locked in a cabinet. LPA reviewed resident medications R1 and found that no medication list was on file for R1. All other residents had a centrally stored list on file. Deficiency was cited and plan of correction was created with staff. Disaster preparedness: LPA reviewed the facility's emergency and disaster plan. LPA observed all facility exits were clear from obstructions. An exit interview was conducted where a copy of this report along with LIC809-D page, and appeal rights were provided to Facility Representative Michael Anisimov.