Routine inspection·February 22, 2024

Licensing Program Analyst (LPA) Janira Arreola conducted a required annual visit. LPA was greeted and was granted entry and met with Licensee and Administrator, Agnes Martinez, who was informed of the purpose of the visit. At time of visit there were (4) residents and (3) staff present. The facility is a one story home with (5) bedrooms and (4) bathrooms with attached garage. The facility does not have a pool or fire arms. The facility is a residential care facility for the elderly serving elderly ages 60 and above. LPA observed the following: Infection Control: LPA observed hand hygiene supplies, PPE equipment and cleaning supplies to do regular cleaning of the facility. The facility has a infection control plan on file. 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. Laundry equipment was observed to be in good working condition. The carbon monoxide detector was tested and operational during the visit. 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 food items. Record Review and Resident/Staff Files: LPA reviewed staff files and training along with CPR/First Aid. Resident files were reviewed and possessed all required paperwork, except for Resident #1 (R1) file which did not have an updated LIC602 with last LIC602 dated 9/10/2021, for resident with diagnosis of dementia. Deficiency and plan of correction was documented with licensee. One resident Resident #2 (R2) also did not have a written record of care on file. deficiency was cited and plan of correction was created with licensee. Health Related Services/ Incidental Medical Services: All client medication was locked in a kitchen cabinet. LPA reviewed client medications and found that MARS and medication was accounted for and had required labeling. Disaster preparedness: LPA reviewed the facility's emergency and disaster plan. LPA reviewed documentation showing last fire drill conducted on 1/11/2024. An exit interview was conducted where a copy of this report, along with LIC809-D page, LIC9098 form, and appeal rights were reviewed and provided to Licensee and Administrator, Agnes Martinez.