Routine inspection·December 27, 2023

Licensing Program Analyst (LPA) Janira Arreola conducted a required annual visit. LPA was greeted and was granted entry and met with Administrator, Elizabeth Pelayo, who was informed of the purpose of the visit. At time of visit there were (6) residents and one (2) staff present. The facility is a one story home with (6) bedrooms and (4) bathrooms with attached garage. The facility does not have a pool or fire arms. The facility is residential care facility for the elderly serving residents ages 60 and above. LPA conducted a tour of the interior and exterior, reviewed facility documents and conducted interviews. LPA observed the following: Infection Control: LPA observed the hand washing stations in the facility restrooms and kitchen had hand hygiene supplies. LPA observed PPE equipment and cleaning supplies to do regular cleaning of the facility. The facility has a plan on how to mitigate infectious disease and train staff. Physical Plant: Physical plant, floors, windows, and doors were observed to be clean and fixtures and furniture were present and in good repair. The facility's outdoor area was observed to be free of hazards. The sharp and dangerous objects were observed to be locked and inaccessible to clients. The smoke and carbon monoxide detectors were operational. Food Service: LPA observed facility kitchen had the ability to prepare food in clean environment and possessed equipment in good working condition. LPA observed the facility met the required 2-day supply of perishable and 7-day supply of non-perishable foods. Record Review and Resident/Staff Files: LPA reviewed staff files and training that contained staff criminal clearance and updated training along with CPR/First Aid. Client files were reviewed and possessed all required paperwork. Health Related Services/ Incidental Medical Services: All client medication was locked in a kitchen cabinet. LPA reviewed resident medications and Resident #1 (R1) had (2) medications, Medication #1 (M1) and Medication #2 (M2) that were not being administered as indicated on medication labeling. Deficiency was cited and plan of correction was created with administrator. Disaster preparedness: LPA reviewed the facility's emergency and disaster plan. LPA reviewed documentation showing last fire drill conducted on 9/21/23. Technical note was documented for facility to conduct fire drill by 12/31/23. LPA observed all facility exits were clear from obstructions. An exit interview was conducted where a copy of this report was provided to Administrator, Elizabeth Pelayo.