Routine inspection·April 8, 2025

On 4/8/2025, Licensing Program Analyst (LPA) Arvin Villanueva arrived unannounced at this facility to conduct their annual inspection visit. LPA met with the administrator, Annie Lyn Rodriguez, and stated the purpose of this visit. Present today visit were 6 residents in care with 2 staff on duty. It was learned that there were (3) residents under the care of hospice at this time. This facility has an approved hospice waiver for (3) residents at any given time. This facility also has, on file, a program to accept and retain residents diagnosed with dementia at this time. A tour of this facility was conducted. Administrator certificate was observed to be present and in compliance at this time. Kitchen area was toured. Cabinets and drawers were reviewed. Food preparation stations, dishwashing station, and other areas intended for meal preps were toured. During the inspection of the kitchen, LPA observed a small fridge that is locked; per discussion with the administrator, it contains resident's medication that require refrigeration. Food supply was reviewed for adequate 2-day perishable and 7-day nonperishable quantities at this time. A tour of the dining area, living area, and all other areas intended for resident use was conducted. Medication cabinet, located in the office area, was reviewed. The medication cabinet was observed to be locked and made inaccessible to the residents at this time. A tour of 3 of 4 resident bedrooms and 1 of 2 restrooms was conducted. Furniture and furnishings were observed to be sufficient and able to meet the needs of the residents at this time. Grab bars and non skid mats were observed to be present and in good repair at this time. Hot water temperature was taken in 1 of 2 bathroom and measured at 109 degrees Fahrenheit. Room temperature during this visit was measured at 71 degrees Fahrenheit. {1 of 2} Linen closet, located in the resident hallway cabinet, was observed to contain a sufficient supply of towels, blankets, and linens to meet the needs of the residents at this time. Fire extinguishers, located throughout this facility, were observed to have been annually inspected on 3/5/25. Facility conducts quarterly emergency drills. First aid kit was observed to be present and contained all of the required components at this time. Exterior grounds of this facility were toured. A review of the facility perimeter fence, side gates, and exits was conducted and found to be in good repair at this time. A review of (3) facility resident files was conducted and noted on the following LIC 858. 1 of 3 resident did not have PRN authorization on file. Per discussion with the administrator, she will obtain one from hospice doctor. A review of (2) facility personnel files was conducted and noted on the following LIC 859. Both staff reviewed are associated to this facility and have current 1st aid/CPR certificate. During this visit, 2 residents were watching TV at the living room, 2 residents were in their bedroom and one resident had a visitor from an outside agency. The following forms and documents were obtained during this visit: LIC 308 - Designation of administrative responsibility LIC 409 - Administration organization LIC 500 - Personnel report LIC 610E - Emergency Disaster Plan Lease Agreement No deficiencies were observed from today's visit. Exit interview was conducted and a copy of this report was provided. {2 of 2}