Routine inspection·November 6, 2024

Licensing Program Analyst (LPA) Sabrina Calzada arrived unannounced to conduct a required annual inspection and met with Eva Tajiti, caregiver. Administrator Designee, Russelle Robinson, arrived shortly. LPA explained purpose of inspection. The facility is licensed for (6) non-ambulatory residents, (1) of whom may bedridden, and has a hospice waiver for (3). There are currently (6) residents and (0) residents are under hospice care. LPA observed (2) residents in the common area, and (3) residents in their rooms at the start of the inspection. (1) resident was sent to the hospital today. LPA and the Administrator Designee toured the interior and exterior of the facility including the common areas, (6) resident bedrooms with half bath, (2) full bathrooms, kitchen, staff room and locked laundry area. LPA observed the facility to be clean, in good repair and odor-free, and the bathrooms have the necessary grab bars, non-skid flooring, paper towels and hand-washing posters. LPA observed sufficient 2+day perishable and 7+day non-perishable supply of food, and locked sharps and toxins in the kitchen and medications are locked in the office. There are sufficient linens/towels/blankets/PPE, and the inside temperature measured 73*F. Fire extinguisher was last serviced 6/19/24, and the facility conducts quarterly fire drills. LPA observed (2) unlocked gates from the inside back patio. There is sufficient outdoor space with seating and shade, and there are not any pools/ponds. Hot water measured 118*F in the kitchen, and there is a complete First Aid kit. Each exit door has a working alarm. All required postings are in the common area. (3) resident files were reviewed and found to be complete with current documentation. Medications were reviewed for (2) residents- orders match medications being administered. (2) staff files were reviewed. Both staff have documentation of completing initial or ongoing required training, including First Aid/CPR. Facility will organize vehicle maintenance records in a binder. LPA observed valid current insurance and registration. Administrator certificate #605337740- exp 6/14/24- pending renewal. RCFE Adm Designee certificate # 6056696740-exp 12/10/2024. An updated copy of current liability insurance was obtained. LPA requested an updated LIC500 and LIC308 by 11/13/24. There are no deficiencies issued. Exit interview with Administrator. Copy of report provided.