Routine inspection·May 16, 2025

Licensing Program Analyst (LPA), Armando Perez made an unannounced visit to the facility for the purpose of conducting a required annual inspection. The LPA was granted entry by staff to conduct the inspection and met with Executive Director Maria Forkrud. The LPA informed the Administrator of the purpose for the visit. The inspection included the following: LPA toured Building C, which is designated as the assisted living section, inside and outside. LPA observed the facility to be clean and in good repair. The building is maintained at a comfortable temperature for the clients. Lighting is sufficient for safety and comfort. Water temperature measured within regulation in 8 randomly selected rooms. There are grab bars for each toilet, bathtub and shower used by residents. Resident showers have non-skid mats present. Laundry facilities and a locked cabinet is present for storing laundry soap and other chemicals on the first floor. All outdoor and indoor passageways are free of obstruction. Emergency lighting is available. There is a telephone working at this location. The LIC 610, emergency disaster plan is maintained. There are no firearms at this facility and no bodies of water observed. LPA began review of client records. Ten (10) records were reviewed. LPA reviewed for identification and emergency information, admission agreement, medical assessment, and TB test results, needs and service plans, placement, functional assessment, centrally stored medication/destruction records, safeguard for personal property/valuables, and personal rights notification. LPA observed client records to be available and complete. LPA reviewed employee records- Ten (10) records were reviewed. LPA reviewed employee records for first aid certification, criminal record clearance or an exemption, health screening and TB test results, employee rights, training verification, and current administrator certification; expiration date 11/04/2025. LPA observed four out ten records did not have the health screening/ TB test results completed and four out of ten did not have the First Aid/CPR certification completed. A deficiency will be issued for each violation. LPA observed facility kitchen had the ability to prepare food in clean environment and possessed equipment in good working condition. Food supply meets the requirement of one (1) week supply of nonperishable and two (2) day supply of perishables. Emergency food and water supply is present. Medications are centrally stored. There is a locked room in the first floor allocated for medication storage. Centrally stored medication and destruction logs are maintained. Medications reviewed appear to have been dispensed accurately. LPA made observation throughout the inspection process to assess if the facility remains in conformity with the State Fire Marshall regulations. Smoke detectors and carbon monoxide detectors were tested and found to be operational. Fire extinguishers was last serviced on 11/26/2024, Fire drills are conducted monthly at the facility with the last drill on 04/01/2025 . Based on the information received during this visit today in the areas reviewed, there are deficiencies that are being cited per Title 22, Division 6 of The California Code of Regulations. This LIC 809, LIC 809-C, 809-D and Appeal Rights report was reviewed with the facility representative and a copy was provided.