Routine inspection·October 21, 2024

On 10/21/2024 at 09:02 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 Melanie Morris was contacted and arrived at the facility during the visit. At the time of the visit there were four (4) staff present, and four (4) residents present. The facility is a four (4) bedroom, three (3) 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 residents of which one (1) may be bedridden. The facility’s approved for six (6) hospice waiver. The facility's vendorized by Inland Regional Center (IRC). The current census is four (4) 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 but outdoor obstructions were observed. Deficiency will be issued. The facility is maintained at a comfortable temperature of 75 degrees Fahrenheit. LPA Brown inspected resident bedrooms; they are equipped with required furniture such as: mattresses, night stands, storage space, and sufficient lighting; bathrooms were clean, and appliances were operating appropriately. LPA Brown observed sufficient furniture throughout the facility. LPA Brown measured and observed the water temperature in the bathroom to be at 131 degrees Fahrenheit. Deficiency will be issued. The facility is equipped with combined operating smoke detectors and carbon monoxide alarms. Two (2) fire extinguishers were 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 *** LPA Brown observed Resident #1 (R1) and Resident #2 (R2) have half bed rails. Administrator Morris reported to LPA Brown that R1 and R2 don’t have written order from their physician indicating the need for half bed rail for mobility. Deficiency will be issued. Furthermore, during the tour of the facility, LPA Brown observed no night light maintained in hallway and passage to one (1) of the residents' shared bathroom. Deficiency will be issued. LPA Brown observed obstruction in the outdoor passageway as evidenced of broken patio umbrella and in disrepair tables. Deficiency will be issued. There was a designated storage space for resident/staff files. There is a cabinet with the resident’s medications locked observed. Cleaning supplies, toxins, sharps, and other dangerous items were kept inaccessible to residents in care. LPA Brown observed a 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 during the visit 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 two (2) resident files for admission agreements, updated physician reports, pre-placement appraisals, centrally stored medication lists and needs and services plans. LPA Brown observed file reviewed were LPA Brown reviewed four (4) staff files for First Aid/CPR and CPI certification, criminal record clearance, trainings, and health screenings and tuberculosis (TB) test with test result. LPA Brown observed Staff #4 (S4) with criminal record clearance but the facility did not transfer S4 criminal background clearance prior to employment on 08/27/2024. Deficiency and civil penalty with the amount of $500.00 will be issued today and will continue to be assessed of $100.00/day until corrected. Medications/Medication Administration Record (MAR) were audited for two (2) residents, LPA Brown observed no issue. Personal and Incidentals were audited (P and I) were audited for two (2) residents, and no issues were observed. Furthermore, LPA Brown observed no surety bond maintained at the facility. Deficiency will be issued. ***Continuation in LIC809C *** 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, LIC421BG forms, and Appeal Rights were discussed and provided to Administrator Melannie Morris.