Routine inspection·August 6, 2021

On 8-6-21 at 8:45 am Licensing Program Analyst (LPA) Tirzah Hubbard and Licensing Program Manager Stephen Richardson arrived unannounced to conduct a Required Annual 1 Year inspection. LPA and LPM met with Una Waqala Administrator and stated the purpose of today’s visit. LPA and LPM were allowed entry into the facility that is licensed to serve a total capacity of 10 clients. Census: 9 Ratio: 2:9 Fully Vaccinated residents: 5 Partially vaccinated: 4 Fully Vaccinated staff: 3 LPA and LPM interacted with a random number of residents during this visit. Designated Administrator stated, "Staff testing for Covid-19: none Resident testing: none". The physical plant was toured inside and outside to ensure the safety of the residents. LPA and LPM toured the kitchen area, backyard, front yard, bedroom 1, bedroom 2, bedroom 3, and bedroom 4. LPA interviewed a number of residents in the facility. LPA observed when entering the facility 2 Staff present during the visit. LPA observed the physical plant of the facility in moderate condition. LPA observed the flooring of the facility in good condition and hallway flooring in good condition. LPA observed the facility conducts fire drills every 6 months. LPA observed medication not stored and locked away inaccessible to persons in care located on the counter and in cabinets that contained no locks. LPA observed medication not logged into from the dates 8/2/21- 8/6/21 in Medication Administration record (MARS). LPA interviewed S1 to discuss medication storage and MARS daily logs to go over medication procedures. LPA interviewed Residents who indicated they have not received medication for 2-3 days and have not had their medication refilled as requested. R5 Stated, " my leg has been hurting and I am in pain." R1 stated, " I am not feeling well today and the staff has done nothing about it". LPA observed the kitchen area containing dead bugs on the counter and corners. The refrigerator contained food items not properly labeled or packaged. The freezer contained un-packaged and unlabeled meat with freezer burn. LPA observed eggs stored in the cabinet where facility binders are stored. LPA observed no food supplies of staple nonperishable food stored for emergency. There were no perishable foods for a minimum of two days that shall be maintained on the premises at all times. The sharp objects that are : Knives, can openers, scissors locked away. LPA observed in backyard fence in disrepair, along with old mattresses and bedframes. The backyard contained an old broken dresser. LPA observed window panel next to trash window blinds in disrepair. LPA observed bedroom 1 with broken dresser, bedroom 2 contained broken dresser and bedroom 3 in compliance. LPA observed in bedroom 4 R4 has not been changed since yesterday on 8-5-21 and has been sitting in urine all day. LPA observed medication not distributed to residents for breakfast time. The temperature inside the facility was measured at 75 *F which is within the required range of 68 degrees F (20 degrees C) and 85 degrees F (30 degrees C), or in areas of extreme heat the maximum shall be 30 degrees F (16.6 degrees C) less than the outside temperature. The hot water was measured at 105*F which is not less than 105 degrees F (40.5 degrees C) and not more than 120 degrees F (48.8 degrees C) as per Title 22 regulations. The first aid kit was found in compliance containing at least the following: a current edition of a first aid manual approved by the American Red Cross, the American Medical Association or a state or federal health agency, sterile first aid dressings, bandages or roller bandages, adhesive tape, scissors, tweezers, thermometers, and Antiseptic solution. LPA Tirzah Hubbard observed a pull alarm system, fire extinguisher(s), smoke and carbon monoxide detectors, central heating and air in the facility. LPA observed the smoke detectors in residents room. LPA observed no smoke detector in dining and kitchen area. Documents requested during visit: LIC 308, LIC 602, MARS Medication log, LIC500, Per the California Code of Regulations, Title 22, Division 6, Chapter 8, multiple deficiencies were observed located on 809D. Exit interview held, copy of report given.