Routine inspection·February 27, 2024

On 02/27/2024 at 09:30 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. Licensee/Administrator Leslie Vannoy was contacted and arrived at the facility during the visit. At the time of the visit there were three (3) staff present, and six (6) residents present. The facility is a five (5) bedroom, three (3) bathrooms with a kitchen/dining area, and living room/activity room and garage. The facility is Residential Care Facility for the Elderly (RCFE). The facility is licensed for a capacity of six (6) non-ambulatory residents, approved for six (6) hospice waivers. The current census is six (6) residents. LPA Brown was accompanied by Staff #2 (S2) 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 Division (CCLD). There are no obstructions to indoor and outdoor passageways. The facility is maintained at a comfortable temperature of 72 degrees Fahrenheit. 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 temperature in a resident bathroom to be at 112 degrees Fahrenheit. During the tour of the facility, LPA Brown observed four (4) inches scissor in the kitchen drawer, not locked and accessible to residents in care. Deficiency will be issued. Moreover, LPA Brown observed one (1) window screen in disrepair, the shared room of Resident #3 (R3) and Resident #4 (R4). Deficiency will be issued. The facility is equipped with operating combined smoke detectors and carbon monoxide alarms. Fire extinguisher was also observed at the facility. Posters such as personal rights, the CCLD complaint poster, Ombudsman poster labor laws, and the disaster plan were posted in a common area. ***Continuation in LIC809C *** Cleaning supplies, toxins, were kept inaccessible to residents in care. There was a designated storage space for resident/staff files. There is a Medicine cabinet with the resident’s medications locked. However, LPA Brown observed residents whole day of medications pre-poured. Deficiency will be issued. A complete first aid kit and first aid book at the facility. Furthermore, during the tour of the facility on 02/27/2024, LPA Brown observed Resident #4 (R4) with half bed rail and no written order from R4's physician indicating the need for half bed rail for mobility. Deficiency will be issued. Also, LPA Brown observed Resident #2 (R2) with full bed rail. Staff #5 (S5) removed the full bed rail during the visit on 02/27/2024. 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 three (3) resident files for admission agreements, updated physician reports, pre-placement appraisals. LPA Brown observed resident files reviewed were complete. LPA Brown reviewed three (3) staff files for First Aid/CPR certification, criminal record clearance, trainings, and health screenings with tuberculosis (TB) test result. LPA Brown observed staff files reviewed were complete. Medications were audited, and LPA Brown observed Resident #2 (R2) medication was dispensed without medication record maintained at the facility. Deficiency will be issued. Based on the observations made during today’s visit, deficiencies were issued per Title 22, Division 6, of the California Code of Regulations. An exit interview was conducted, and this report (LIC809), LIC809D, LIC9102 and Appeal Rights were discussed and provided to Licensee/Administrator Leslie Vannoy.