Routine inspection·February 23, 2024

On 02/23/2024 at 09:45 AM, Licensing Program Analyst (LPA) Melody Brown made an unannounced visit to the facility. The purpose of the visit was to conduct a required comprehensive annual inspection. LPA Brown met with a staff and was granted entry to the facility. Administrator Hanan Hamed met with LPA Melody Brown during the visit. At the time of the visit there were three (3) staff present, and twenty-three (23) residents present. The facility is a fourteen (14) bedroom, four (4) bathroom home with a kitchen/dining area, living room/activity room. The facility is Residential Care Facility for the Elderly (RCFE). The facility is licensed for a capacity of twenty-five (25) non-ambulatory residents and approved for six (6) hospice waiver. The current census is twenty-three (23) residents. LPA Brown was accompanied by Administrator Hanan Hamed to conduct a general overall inspection, which included, but was not limited to, the following: Physical Plant: The facility is operating in the capacity approved by Community Care Licensing (CCL). There are no obstructions to indoor and outdoor passageways. The facility is maintained at a comfortable temperature. LPA Brown inspected resident bedrooms; they are equipped with required furniture such as: mattresses, nightstands, storage space, and sufficient lighting; bathrooms were clean, and appliances were operating appropriately. LPA Brown observed sufficient furniture and lighting throughout the facility. LPA Brown measured and observed the water temperatures in the bathroom to be at 106 degrees Fahrenheit. The facility is equipped with operating smoke detectors and carbon monoxide alarms. Fire extinguishers were also observed at the facility. Posters such as personal rights, the CCL complaint poster, Ombudsman poster, labor laws, and the disaster plan were posted in a common area. ***Continuation in LIC809C *** During the tour of the facility, LPA Brown observed two (2) screen window in disrepair. Deficiency will be issued. Cleaning supplies, toxins, sharps, and other dangerous items were kept inaccessible to residents in care. There was a designated storage space for resident/staff files. There is a Medicine Cabinet for the residents with the resident’s medications locked. LPA Brown observed the complete first aid kit and first aid book at the facility. Food Service: More than seven (7) days’ supply of Non-perishable foods and more than two (2) days’ supply of perishable food supply were observed and sufficient for the number of residents in care. Care & Supervision: The facility has an Administrator present in the facility with appropriate and enough hours to appropriately manage the facility. The facility has sufficient number of staff to provide care and supervision to the residents in care. Record Review: LPA Brown reviewed four (4) resident files for admission agreements, updated physician reports, pre-placement appraisals and needs and services plans. LPA Brown observed resident files reviewed were complete. LPA Brown reviewed four (4) staff files for First Aid/CPR certification, criminal record clearance, trainings, and health screenings. LPA Brown found that Staff #4 (S4) does not have Health Screening Report with Tuberculosis (TB) Result. Deficiency will be issued. Also, LPA Brown observed S4 did not complete the required 24 hour initial training. Deficiency will be issued. Moreover, Administrator Hamed reported that they have one (1) dementia resident and LPA Brown observed no staff at the facility completed trainings in dementia. Deficiency will be issued. Furthermore, LPA Brown observed no earthquake drill completed at the facility. Last Fire In-Service completed on 10/24/2023 but no Fire Drill completed. Deficiency will be issued. Medications/Medication Administration Record (MAR) were audited, and LPA Brown observed no issue. Based on the observations made during today’s visit, deficiencies were cited per Title 22, Division 6, of the California Code of Regulations. An exit interview was conducted, and this report (LIC809), LIC809D, LIC9102 forms, and Appeal Rights were discussed and provided to Administrator Hanan Hamed