Routine inspection·November 19, 2024

Licensing Program Analysts (LPAs) Vincent Moleski and Holly Williams arrived unannounced to conduct an annual inspection. LPA Moleski met with facility administrator Beatriz Afalla and explained the purpose of the visit. LPA Moleski reviewed five resident files (R1-R5) and three staff files (S1-S3). LPA Moleski observed that there was no LIC 602 present in R2's file. Afalla said it was misplaced. LPA Moleski observed in R4's file an LIC 602 dated 12/28/24, which diagnosed R4 with a "pressure ulcer of sacral region & buttock, unstageable." LPA Moleski reviewed R4's discharge paperwork from a skilled nursing facility dated 12/31/23, which was prepared prior to R4's release to this facility. The discharge paperwork stated that R4 had pressure injuries on their left heel, sacrum, and left and right buttocks. Afalla said R4 has never been on hospice. Afalla said that the wounds have since healed. LPA Moleski observed in R5's file an LIC 602 dated 11/2/23, which diagnosed R5 as bedridden. LPA Moleski observed that R5 is currently residing in room #3. This facility's fire clearance approves one bedridden resident only in room #1. LPA Moleski toured the facility with Afalla 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 70 degrees Fahrenheit, which is within the required range of 68 and 85 degrees. The facility's water temperature measured 110 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 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) and LPA Williams interviewed one resident (R1). This facility is hereby cited per 22 CCR Section 87606(c), 87615(a)(1), and 87458(a). An immediate civil penalty in the amount of $500 for a fire clearance violation is hereby assessed. An exit interview was held with Afalla. Appeal rights and a copy of this report were left with Afalla.