Routine inspection·February 21, 2025

Licensing Program Analyst (LPA) Vincent Moleski arrived unannounced to conduct an annual inspection. LPA Moleski met with facility administrator Faith Paras and explained the purpose of the visit. LPA Moleski reviewed four resident files (R1-R4) and three staff files (S1-S2 and Paras' file). S1 did not have a health screening or tuberculosis test on file. S2's health screening indicated that they required treatment after a positive tuberculosis test. S2 said they were prescribed antibiotics after the test. No documentation was available to show S2 was free of active, communicable tuberculosis after their antibiotic treatment. Paras' first aid/CPR certification, dated 2/20/23, was expired as of today, 2/21/25. R4 did not have a needs and services plan on file. While reviewing this facility's medication administration records, LPA Moleski observed many missing signatures for doses of several different medications for more than one resident in the month of February 2025. LPA Moleski reviewed two residents' centrally stored medication records and observed that medication start dates were not recorded, making an audit of dosages impossible. LPA Moleski photographed the record of missing dosages and start dates. LPA Moleski toured the facility with Paras and inspected common areas, the kitchen, bedrooms, bathrooms, and backyard areas. Furniture and furnishings were sufficient to meet the needs of residents. The facility temperature was 73 degrees Fahrenheit, which is within the required range of 68 and 85 degrees. The facility's water temperature measured 111 degrees Fahrenheit, which is within the required range of 105 and 120 degrees. While touring this facility, LPA Moleski observed a surveillance camera present in a common area. LPA Moleski asked if the camera captured audio. Paras said it did. LPA Moleski asked Paras if the facility's approved plan of operation permitted the use of video surveillance. [continued on 809-C] After reviewing the plan of operation, Paras said it did not. Paras removed the camera during this visit. LPA Moleski observed first aid supplies, a fully-charged and up-to-date fire extinguisher, and carbon monoxide/smoke detectors. LPA Moleski observed a minimum 2-day supply of perishable food and a minimum 7-day supply of nonperishable food. LPA Moleski observed a locked cabinet for the storage of medication. LPA Moleski observed locked cabinets for the storage of cleaning solutions and knives. LPA Moleski interviewed one staff member (S1) and one resident (R1). This facility is hereby cited per 22 CCR Sections 87468.2(a)(1), 87465(a)(6), 87411(f), and 87411(c)(1), and HSC Section 1569.695(e)(2). An exit interview was held with Paras. Appeal rights and a copy of this report were left with Paras.