Routine inspection·October 3, 2024

On 10/3/2024, Licensing Program Analysts (LPAs) Janette Romero and Janira Arreola made an unannounced visit to the facility to conduct a required annual inspection. LPAs were greeted and granted entry by Caregiver, Angelica Alamillo who was informed of the purpose of the visit. The facility has a fire clearance for six (6) non-ambulatory elderly residents. The facility also has an approved hospice waiver for four (4) residents and LPA was informed two (2) residents are currently receiving hospice services at the facility. During the visit, there was two (2) staff and five (5) residents present. Facility representative, Adeola Ayodele arrived during the visit. LPA toured the facility with Caregiver Alamillo, conducted interviews and reviewed records. During the tour, LPA observed indoor and outdoor pathways were free of obstructions. There were no bodies of water observed on the premises. Outdoor shaded seating is available for the residents in care. LPA toured the kitchen and observed the facility has a two-day supply of perishable foods and seven-day supply of non-perishable food items. Knives are secured in a locked kitchen cabinet next to the refrigerator. Cleaning solutions and disinfectants are secured in the locked garage. Caregiver Alamillo tested one (1) of the smoke alarms/carbon monoxide detectors and LPA observed it to be operational. LPA also observed charged fire extinguishers mounted throughout the facility, last serviced on 6/4/2024. Staff present have a criminal record clearance and are associated with the facility. Medications are secured in a locked hallway closet. LPAs reviewed the physical medications for Resident 1 (R1) and Resident 2 (R2) along with their Medication Administration Record for October 2024 and found facility staff documented administering a medication for R2 that is not listed in the latest medication list and was not found with their physical medications. Staff interviews conducted revealed facility staff are documenting administration of R1's routine medications for October 2024 on 10/3/2024 and not immediately after dispensing the medication from 10/1/2024 to 10/3/2024. During today's visit, the facility was issued one (1) deficiency. An exit interview was conducted and a copy of this report was reviewed and provided to facility representative, Adeola Ayodele along with an LIC 809-D, Confidential Names List (LIC 811) and Appeal Rights.