Routine inspection·March 18, 2024

Licensing Program Analyst (LPA) Magda Malcore made an unannounced visit to the facility to conduct a required annual inspection. LPA met with Elizabeth Zarate , Assisting Administrator, and discussed the purpose of the visit. The facility is a Residential Care Facility for the Elderly (RCFE) with a license capacity of (6), a current census of (6) residents, and a hospice waiver for (2). LPA conducted an overall inspection of the facility, which included, but was not limited to, the following: Physical Plant/Environment: Indoor and outdoor passageways are free of obstruction. The facility has no swimming pools or similar bodies of water. The facility's backyard area is sufficient for resident activities and is enclosed with a self-latching gate. Resident’s showers, toilets, and hand washing areas were operating in a safe and sanitary condition. Resident bathrooms were equipped with grab rails and non-skid flooring or non-skid mats. The hot water temperature in residents' bathrooms measured 111 degrees F. Resident’s bedrooms had beds, chairs, night stands, sufficient lighting and maintained at a comfortable temperature. The facility had operating carbon monoxide alarms, laundry equipment, and telephone service. The facility had sufficient linen, towels, and personal hygiene items for residents. The facility had sufficient activity supplies for residents in care. The facility's fire place is kept covered. Disinfectants and cleaning solutions were kept locked and inaccessible to residents in care. The facility has posted in a common area, Ombudsman poster, facility license, and evacuation exit plan sketch; However, the facility did not have posted, a list of emergency telephone numbers and a Residential Care Facility complaint poster. Deficiency cited. Care & Supervision : Facility has 24-hour, 7 days a week direct care staff. Food Service: Facility kitchen and dining areas are maintained clean. The facility has sufficient non-perishable and perishable food supply for residents in care. Sharps were kept locked and inaccessible to residents in care. Record Review: Review of (5) staff files reveal: staff#1 (1), staff#2 (S2), staff#3 (3), staff#4 (S4), staff#5 (S5) did not have documentation of in-service annual Dementia training on file. S1 and S5 did not have documentation of CPR/First Aid training on file. Review of (5) resident files reveal: resident #1 (R1) did have a pre-admission appraisal on file. The facility did not maintain record of a current quarterly drill conducted with staff. The facility’s last fire/earthquake drill on file was conducted on 12/14/2022. Deficiency cited. Medical Related Services : Resident’s medications are labeled and centrally stored in a locked room. The facility had sufficient first aid supplies. A first aid manual is kept at the facility. Based on observations and record review, deficiencies are being cited per Title 22, of The California Code of Regulations and Health and Safety Codes. This report was reviewed with the Assisting Administrator and a copy with Appeal Rights was provided to the Assisting Administrator at the conclusion of the visit.