Routine inspection·September 10, 2024

On 9/10/2024 at 09:25 AM, Licensing Program Analysts (LPA) Melody Brown and Eldin Serrano made an unannounced visit to the facility. The purpose of the visit was to conduct a required comprehensive annual inspection LPAs Brown and Serrano met with Licensee/Administrator Charisse Magsaysay and was granted entry to the facility. At the time of the visit there were two (2) staff present, and five (5) residents present. The facility is a five (5) bedrooms, five (3.5) 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 six (6) non-ambulatory and six (6) hospice care and 1 maybe bedridden resident and the current census is five (5) residents. LPAs Brown and Serrano was accompanied by Staff #3 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 74 degrees Fahrenheit. LPAs Brown and Serrano 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. LPAs Brown and Serrano observed sufficient furniture and lighting throughout the facility. LPAs Brown and Serrano measured and observed the water temperatures in the bathroom to be at 107 degrees F at Room # 5. 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 CCLD complaint poster, labor laws, and the disaster plan were posted in a common area. LPAs Brown and Serrano observed resident 2 (R2) and resident 3 (R3) have half bed rails. Licensee/Administrator Magsaysay reported to LPAs Brown and Serrano that R2 and R3 do not have written order from their physician indicating the need for half bed rail for mobility. Deficiency will be issued. continuation on LIC 809C 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 Closet with the resident’s medications locked. LPAs Brown and Serrano observed 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. Also, LPAs Brown and Serrano observed that the facility does not have dementia residents. Record Review: LPAs Brown and Serrano reviewed three (3) resident files for admission agreements, updated physician reports, pre-placement appraisals and centrally stored medication list and needs and services plans. LPAs Brown and Serrano observed that resident 1(R1) and resident 3 (R3) do not have the required pre-placement appraisal in their facility file. Deficiency will be issued. LPAs Brown and Serrano observed resident 3 (R3) physician report does not have a physician signature date. Deficiency will be issued. LPAs Brown and Serrano observed that resident 1 (R1), resident 2 (R2), resident 3 (R3) do not have the required needs and services plan. Deficiency will be issued. LPAs Brown and Serrano reviewed four (4) staff files for First Aid/CPR certification, criminal record clearance, trainings, and health screenings and tuberculosis (TB) test. LPAS Brown and Serrano observed that staff 4 (S4) does not have the required health screening report and TB test. Deficiency will be issued. During the visit S4 complete the required health screening report and TB test. Medications/Medication Administration Record (MAR) were audited, and LPAs Brown and Serrano observed resident 1 (R1) four (4) medications were not given per R1 physicians order. Also, LPAs observed resident 3 (R3) one medication was not given per R3 physicians order. Moreover, LPAs observed R3 one (1) medication was not refilled on time, thus not given per R3's physician order. Deficiency will be issued. 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, LIIC809D, LIC9102 forms, and Appeal Rights were discussed and provided to Licensee/Administrator Charisse Magsaysay