Routine inspection·September 10, 2024

Licensing Program Analyst (LPA) Mary Rico made an unannounced visit to the facility. The purpose of the visit was to conduct a required comprehensive annual inspection. LPA met with House Manager Marco Pascaran and was granted entry to the facility. Licensed capacity is (6) current census (4). LPA was accompanied by House Manager Marco Pascaran 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 (CCL). There are no obstructions to indoor and outdoor passageways. The facility is maintained at a comfortable temperature. LPA inspected client 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 observed sufficient furniture and lighting throughout the facility. Posters such as personal rights, the CCL complaint poster, and the disaster plan were posted in a common area. Cleaning supplies, toxins, sharps, and other dangerous items were kept inaccessible to clients in care. There was a designated space for client/staff files. Food Service: Non-perishable and perishable food supply is sufficient for number of clients in care. Facility has a variety of food available for clients. Dishes, cups, and utensils were also stored properly. Care & Supervision: Facility has sufficient care staff for coverage 24 hours a day, 7 days a week. Record Review: LPA reviewed (4) resident files for admission agreements, updated physician reports, and needs and services plans. LPA reviewed (4) client medications. During medication audit LPA observed 1 out of the 4 residents did not have their PRN medication documented with the time, date, dosage, and resident’s response. LPA also reviewed (3) staff files for criminal record clearance, trainings, and health screenings During staff record review, LPA observed the (3) present staff CPR certification expired in July 2024. In addition, the facility did not have an Infection Control Plan created and did not have documentation of their quarterly drills, Based on the observations made during today’s visit, (4) deficiencies were cited per Title 22, Division 6, of the California Code of Regulations. An exit interview was conducted, and this report (LIC809) was discussed and provided to House Manager Marco Pascaran. Along with the appeal rights.