Routine inspection·April 14, 2025

Licensing Program Analyst (LPA) Vincent Moleski arrived unannounced to conduct an annual inspection. LPA Moleski spoke with facility administrator Lyenna Bigelow over the phone and explained the purpose of the visit. LPA Moleski reviewed six resident files (R1-R6) and three staff files (S1-S3). R2 was identified as bedridden on their latest LIC 602, dated 02/07/2025. Comments on the LIC 602 describe the resident as "bed bound," and suffering from motor impairment or paralysis. R2's latest appraisal, dated 02/18/2025, indicated that R2 was in bed all the time. In an interview during this visit, S1 referred to R2 as "bed bound." This facility has a fire clearance for six non-ambulatory residents, but is not cleared to accept or retain any bedridden residents. Medical records from an emergency room visit on 2/24/25 indicate that R3 received a CT scan of their head due to a "fall/ qeustionable [sic.] head injury." The CT scan revealed no internal bleeding or other signs of serious injury. LPA Moleski reviewed fax and email records and observed that no incident reports were received regarding this fall. LPA Moleski observed that three residents' admission agreements (R3, admitted 1/27/25, R4, admitted 2/10/25, and R6, admitted 3/14/25) did not include base rates for basic services. LPA Moleski toured the facility 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 69 degrees Fahrenheit, which is within the required range of 68 and 85 degrees. [continued on 809-C] The facility's water temperature was tested and measured 103 degrees Fahrenheit, which is not within the required range of 105 and 120 degrees. While touring the facility, LPA Moleski observed that the interior garage door was unlocked. LPA Moleski observed many cleaning solutions and chemicals out in the garage. A cabinet labeled "keep locked when not in use" and "must be locked at all times" was unlocked. Several different cleaning solutions were observed inside the unlocked cabinet. LPA Moleski observed one resident (R6) walk into the garage unaccompanied 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 closet 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). Residents were not able to be interviewed during this visit. This facility is cited per 22 CCR Sections 87202(a)(2), 87309(a), 87211(a)(1), 87303(e)(2) and 87507(g)(3)(A). Due to a violation of fire clearance requirements, an immediate civil penalty in the amount of $500 is hereby assessed. An exit interview was held with Bigelow. Appeal rights and a copy of this report were left with staff member Siteri Senitirau.