Routine inspection (multi-day)·January 3, 2024

On 1/3/2024 at 10:15am, Licensing Program Analyst (LPA) Arvin Villanueva arrived at this facility to conduct an unannounced Case Management-Annual continuation visit to continue with the Annual visit initiated on 12/27/2023. LPA initially met with staff on duty and explained the purpose of the visit. The facility assistant administrator, Grant Depositar was informed of the visit and arrived shortly after. Present during this visit were 6 residents in care with 2 staff on duty. During this inspection, LPA conducted an audit of facility files, 6 resident files, and 8 staff files for regulatory compliance. LPA completed resident interviews and 2 staff interviews. 6 out of 6 resident files reviewed contained all required contents including updated admission agreements, medical assessments, and updated appraisal forms as required. 8 out of 8 staff files reviewed contained all required contents including health screening, TB results, current first aid/CPR, and initial and ongoing required trainings. Facility’s liability insurance is current per regulatory requirements. The facility is current on annual license fees. LPA reviewed facility’s disaster plan to ensure regulatory compliance. Facility conducts quarterly fire drills. Medication storage area was observed to be locked and inaccessible to residents in care. Medications were reviewed for accuracy. First aid kit was observed to have adequate supplies and accessible to staff. The facility maintains for each resident Centrally Stored Medication, Destruction Record and PRN Log. LPA observed the facility's infection control practices. LPA observed screening protocols for visitors, staff, and residents, and sanitizing stations in common areas and restrooms. LPA observed facility to have sufficient equipment and supplies to meet activity program needs of residents in care. Note: LPA Villanueva was unable to open the CARE Tools during this visit. Per California Code of Regulations (Title 22, Division 6, Chapter 8), the following deficiencies has been observed and citation issued (ref. LIC 9099-D). {Con't to LIC809-C} {Con't from LIC809} The following deficiencies were observed during today’s inspection: · During medication review, LPA observed that the medication administration record for all 6 residents have missing staff signature on the following dates: 1/2/2024 (all day) and 1/3/2024 (morning). · During staff file review, LPA observed that 1 staff did not have a valid health screen report (LIC503). Staff was hired in 2021 and the LIC 503 on file is from 2017. · During resident file review, LPA observed that 1 out of 6 resident in care did not have a TB test done on record prior to admittance to this facility. Assistant administrator, Grant, attempted to obtain the record from previous residence but per Grant, record of TB test was not obtained. However, a recent record of TB test was done and the result was negative. An exit interview was held with Grant Depositar, and a copy of this report and appeal rights were provided to the facility. Note: *Citations not cleared by the due date will be a $100 fine assessed for each citation until it is cleared. Civil penalties will continue to accrue until Proof of Corrections (POC) is cleared. *