Routine inspection·April 16, 2024

Licensing Program Analyst (LPA) Vincent Moleski arrived unannounced to conduct an annual inspection. LPA Moleski met with facility administrator Mohamed Massaquoi and explained the purpose of the visit. LPA Moleski reviewed two resident files (R1-R2) and three staff files (S1-S3). R1 has a colostomy, according to R1's LIC 602s. LPA Moleski did not observe a current record of care in R1's file for the colostomy, or documentation from a physician that the colostomy wound was healed, or documentation from a physician that R1 was able to manage colostomy care needs independently. Massaquoi said that R1 manages care of the colostomy independently, and said that the wound is healed. Massaquoi said there was no current record of care or other current physician's documentation regarding R1's colostomy. LPA Moleski reviewed medication administration records (MARs) for R1 and R2 for the month of April 2024. LPA Moleski observed that signatures in these MARs were complete through to April 9, 2024. Signatures for medication administrations between April 10 and April 16, 2024, were absent. Massaquoi said that S1 had been providing medication assistance during this time period, but did not sign because S1 has not been trained on medication administration. LPA Moleski reviewed S1's file and observed no training documentation present. LPA Moleski toured the facility with Massaquoi 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 71 degrees Fahrenheit, which is within the required range of 68 and 85 degrees. The facility's water temperature measured 120 degrees Fahrenheit, which is within the required range of 105 and 120 degrees. [continued on 809-C] 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 drawer for the storage of medication. LPA Moleski observed a locked drawer for the storage of knives. A cabinet below the facility's kitchen sink was unlocked. The lock was broken and not functional. LPA Moleski interviewed one staff member (S1) and two residents (R1-R2). This facility is being cited per 22 CCR Sections 87411(d)(4), 87611(b)(1-3) and 87309(a) . An exit interview was held with Massaquoi. Appeal rights and a copy of this report were left with Massaquoi.