Routine inspection·May 22, 2024

On 5/22/24, at 10:15am, Licensing Program Analyst (LPA) Arvin Villanueva arrived at this facility unannounced to conduct the required annual inspection visit. LPA met with the facility administrator, Annie Lyn Rodriguez, and explained the purpose of the visit. Present during today's visit were 5 residents in care with 2 staff on duty. Facility is approved for 6 non-ambulatory resident and fired cleared for 1 bedridden resident. Additionally, facility is approved for 1 hospice resident. At 10:30am, LPA inspected the facility’s physical plant including but not limited to the kitchen, dining room, resident bedrooms, resident bathroom, laundry room, living area, common TV area, and outside of the facility to ensure compliance with Title 22 regulations. The facility is a one-story structure located in a residential neighborhood. There were no bodies of water on the premises at this time. Outside of the facility was observed to be clean and clear of obstructions. LPA observed outdoor furniture for clients’ use. During the inspection outside, LPA observed the fences at the side and the back of the yard are in need of repair. Technical assistance was provided. LPA observed 5 resident bedrooms and 3 resident bathrooms. There is one staff room in the facility. LPA observed beds and bedding supplies were in good condition, adequate lighting was provided, and sufficient storage for the client’s personal belongings. Bed linens, comforters, and bath towels were adequately stocked during the visit. Bathroom is observed to be sanitary, operational and adequately supplied, including with grab bars and non-skid flooring. LPA observed the facility to be furnished at the time of the visit. Storage areas for personal hygiene, cleaning supplies, toxins, and sharps objects were locked and not accessible to residents in care. Facility maintain adequate supply of clean linens for resident use. Food supplies were observed to be stored appropriately. Sufficient 2-day perishable and 7-day non-perishable food was maintained adequately. Room temperature was maintained in the facility at 75 degrees F. Water temperature in the bathroom was measured at 111 degrees F. One fire extinguisher was last serviced on 3/12/24. Smoke detectors/ carbon monoxide were observed. {Con't toLIC809-C} {Con't from LIC809} Medication storage area was observed to be locked and inaccessible to residents in care. Medications were reviewed for accuracy for two residents. First aid kit was observed to have adequate supplies and accessible to staff. The facility maintains for each client Centrally Stored Medication, Destruction Record and PRN Log. All mandated inspection control posters were posted. LPA observed personal rights poster. Facility has internet access available for residents in care. LPA observed sufficient equipment and supplies to meet activity program needs of residents in care. During this visit, residents were in their bedrooms. During this inspection, LPA conducted an audit of facility files, 5 resident files, and 3 staff files for regulatory compliance. All 3 staff files reviewed contained required contents including health screening, TB results, and current first aid/CPR. Resident files contained updated Physician Reports and Needs and Services Plans. Medication review was conducted for 2 randomly selected residents for compliance. No medication issues were observed at this time. Per review, facility conducts quarterly fire drills. Last fire drill was conducted in March 2024. Facility’s liability insurance is current per regulatory requirements. LPA reviewed facility’s disaster plan and infection control plan. LPA was provided updated copy of LIC 308, LIC 500, 1 and liability insurance. No deficiencies were observed during this visit. An exit interview was conducted with Administrator Annie Lyn Rodriguez, and a copy of this report was provided.