Routine inspection·July 27, 2023

Licensing Program Analyst (LPA) Vincent Moleski arrived unannounced to conduct an annual inspection. LPA Moleski spoke with facility administrator Christopher Faamausili over the phone and explained the purpose of the visit. Faamausili said staff member Kim Bennett would be able to sign for him in his absence. LPA Moleski reviewed three resident files (R1-R3) and three staff files (S1-S3). S2's file did not contain documentation of first aid certification. S2 said S2 had a first aid certification from previous employment but was unable to produce documentation. LPA Moleski toured the facility with Bennett and inspected common areas, the kitchen, bedrooms, bathrooms, and backyard areas. Furniture and furnishings were sufficient to meet the needs of residents. While inspecting the backyard, LPA Moleski and Bennett observed a box of several pill bottles, which contained medications, left out. LPA Moleski observed first aid supplies, a fully-charged and up-to-date fire extinguisher, and working carbon monoxide/smoke detectors. LPA Moleski observed a minimum 2-day supply of perishable food and a minimum 7-day supply of nonperishable food. LPA Moleski observed a locked cabinet for the storage of medication. LPA Moleski observed locked cabinets for the storage of cleaning solutions and knives. LPA Moleski interviewed one staff member (S1) and two residents (R3, R4). This facility is being cited per 22 CCR Sections 87465(h)(2) and 87412(g) . An exit interview was held with Bennett. Appeal rights and a copy of this report was left with Bennett.