Routine inspection·March 7, 2024

On 03/07/24 Licensing Program Analyst (LPA) Kimberly Viarella made an unannounced visit to this facility to conduct an annual inspection. LPA identified herself, explained the purpose of the visit, and asked to speak with the Designated Facility Administrator (DFA). LPA met with Designee, Marie "Susie" Dizon, who also has her Administrator's Certificate, #6018733740. A brief interview followed. LPA forwarded the list of documents required for a change of Administrator. The inspection began in the kitchen. All knives and sharps were locked and inaccessible to residents in care. The food supply was adequate for 2-day perishable and 7-day nonperishable. Opened packages in the refrigerator were dated appropriately. LPA inspected the residents' 6 singel occupancy bedroom and 2 staff rooms. All resident rooms had the required furniture, furnishings and lighting to be in compliance at this time. LPA noted grab bars, nonskid surfaces in the shower, soap, paper towels and trashcans with lids in the 2 bathrooms. The hot water temperature was measured to ensure it was between 105 and 120 degrees. The fire extinguisher was last serviced on 10/02/23 by Hangtown Fire Control and was in compliance. The LPA observed medications were stored in a locked closet adjacent to the living room and inaccessible to residents in care. Some medications were in pill packs provided by the pharmacy, others were not. LPA reviewed storage, dosing, and destruction procedures. A review of the First Aid kit by the LPA found it to be complete and in compliance. The exterior of the building was inspected by the LPA. There were no bodies of water present and the yard was completely fenced in. One side of the fence was older than the rest and had loose posts and holes along the base. The Designee stated that their maintenance staff would be repairing it in the near future. LPA observed that all screens and gutters were in good repair. There was 1 storage shed with a lock that contained yard equipment and storage items. There was also a patio area for residents to enjoy. The Designee, could not provide an LIC 500 at the time, LPA compared Guardian roster of background cleared staff to a handwritten roster supplied by the Designee. 1 out of 4 members were not background cleared. LPA reviewed 3 resident files and 3 staff files. Both were complete and in compliance. According to the California Code of Regulations, Title 22, the deficiencies observed during today's inspection were cited and many be found on the LIC809D page. A copy of this report along with APPEAL RIGHTS was provided. Exit interview. This report was amended. 4 out of 4 individuals were background cleared. The appropriate documentation was located after this report had been final printed, the deficiency was removed and the civil penalty was not assessed.