Routine inspection·September 28, 2023

Licensing Program Analyst (LPA) Avelina Martinez made an unannounced visit to this facility to conduct an annual inspection on 09/28/2023 at 8:30 AM. LPA Martinez met with Chelsea Xiong and stated the purpose of today’s visit. LPA Martinez inspected the physical plant including but not limited to the kitchen, dining room, resident bedrooms; resident bathrooms, laundry room, activity room, and outside courtyards of the facility to ensure compliance with Title 22 regulations. Administrator holds current certificate. The facility is licensed for 26 ambulatory residents and 116 non-ambulatory residents, which 10 may be bedridden. In addition, the facility has an approved hospice waiver for 15. There are currently 86 residents who reside at this facility. LPA Martinez toured the facility with Karla Rocha on 09/28/2023 at 2:30 PM. Due to insufficient time, the annual will require a continuation visit. The Department will return at a later date to complete the annual inspection. However, at today's 09/28/2023 annual inspection the following deficiencies were observed: Nine out ten employees were missing first aid certificates. Kitchen freezer measured at 10 degrees. Kitchen refrigerator measured at 47 degrees. Resident 1 (R1) is on a special diet (Gluten Free) However, facility kitchen staff was unaware of special diet and facility staff reported resident 2 (R2) is also on a glutin free diet. The facility has not implemented a glutin free plan. Pond/large body of water procedures are being reviewed by LPA Martinez. As a result of this annual inspection, the following deficiencies can be found on the 9099 D page. In addition, the Department will return at a later date to complete the continuation of this annual visit. An exit interview was conducted, and copy of this report was provided to the facility.