Post-licensing visit·February 12, 2024

Licensing Program Analyst (LPA) Vincent Moleski arrived unannounced to conduct a postlicensing inspection. LPA Moleski met with facility administrator Shane Stumpf and explained the purpose of the visit. Three staff members (S1-S3) were present in the facility upon arrival (S1-S3). None of these three staff members were associated to this facility's roster. Stumpf submitted transfer documents to the Community Care Licensing Division during this visit. LPA Moleski reviewed six resident files (R1-R6) and seven staff files (S1-S7). LPA Moleski toured the facility with Stumpf 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 72 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. LPA Moleski observed 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 (S4) and one resident (R3). This facility is being cited per 22 CCR Section 87355(e)(2) . An exit interview was held with Stumpf. Appeal rights and a copy of this report was left with Stumpf.