Routine inspection·September 13, 2024

Licensing Program Analyst (LPA) Janira Arreola conducted an unannounced annual required visit. LPA was granted entry and met with Administrator, Aron Oda, who was informed of the purpose of the visit. At the time of the visit there was two () 3staff and five (5) residents present. The facility is a two story home, three (3) bedrooms and one (1) bathroom downstairs are designated for residents on the first floor. No pool or firearms are present. Infection Control: LPA observed hygiene supplies, PPE equipment, and cleaning supplies to do regular cleaning of the facility. LPA reviewed the facility's infection control plan which met department requirements. LPA reviewed staff records and found that all staff had infection control training. Physical Plant: Physical plant, floors, windows, and doors were observed to be clean. Fixtures and furniture were in good repair were present. The outdoor area was observed to be free of hazards with outdoor furniture and shaded area for residents. Laundry equipment was observed to be in good working condition. The sharp and dangerous objects were observed to be locked and inaccessible to the residents. The smoke detector and carbon monoxide was operational, and the hot water temperature 105.2F. Care & Supervision / Administration: Adequate staff are present for the supervision of residents during the visit. LPA also reviewed the staff scheduled showing adequate staff coverage. The listed administrator, possesses a current administrator's certificate. The facility liability insurance policy was out of date, the licensee agreed to have this renewed and submitted to LPA. Deficiency was cited. Technical note was documented for the licensee to send the grant deed to the LPA by September 27, 2024. Record Review and Resident/Staff Files: LPA reviewed three (3) staff files and training. All staff have criminal clearance and updated training along with CPR/First Aid Certification. Three (3) resident files were reviewed. One (1) resident who did not have an updated LIC602, the licensee coordinated with the resident's responsible party during the visit and established a date when the resident would see their primary care physician. (1) resident did not have a signed Needs and services plan. Deficiency was cited for the resident to have an updated file. One (1) resident is currently receiving home health services, who did not have a plan of care from the home health agency on file, but does have a plan of care with the facility. Technical note was documented and the licensee agreed to send this plan of care to the LPA by September 27, 2024. Health Related Services/ Incidental Medical Services: All resident medication was locked in a kitchen cabinet. LPA reviewed medications for three (3) residents and found all medication listed on MARS and all required labeling was found to be in place. Disaster preparedness: LPA reviewed the facility's emergency and disaster plan. LPA reviewed documentation showing the facility's last fire and earthquake drill was on 07/20/2024 which met the department requirements. LPA observed all facility exits were clear from obstructions. LPA observed emergency supplies in the garage and first aid kit with all required items. An exit interview was conducted where a copy of this report was provided to Administrator Aron Oda.