Routine inspection (multi-day)·May 14, 2024

On 5/14/24, at 9:35am, Licensing Program Analyst (LPA) Arvin Villanueva arrived to this facility unannounced to conduct an annual continuation visit. The purpose of this visit is to continue the required annual inspection initiated on 4/22/24. LPA initially met with one of the staff on duty and explained the purpose of the visit. The administrator, Maria Magnolia Tolon, was notified of the visit and arrived shortly after along with the licensee, Aida Gatchlian. Present during this visit were 4 residents in care with 2 staff on duty. Note that prior to this visit, a fire inspection was initiated to obtain a fire clearance for the room marked as "staff room" on the facility sketch as resident bedroom. This room is not fire cleared for resident use at this time. Per interview with administrator and licensee, the fire marshal visited on 4/23/24 and suggested to install a ramp for the exit door of this room and will revisit the facility once the Department submit form STD 850 and the installation of the ramp has been completed. LPA Villanueva submitted the form on 5/3/24 to the Consumnes CSD Fire Department. Per today's observation, a fire door has been installed in this bedroom. During this inspection, LPA conducted an audit of facility files, 5 resident files, and 3 staff files for regulatory compliance. All staff files reviewed contained required contents including health screening, TB results, current first aid/CPR, and initial and ongoing required training and are associated to this facility. 5 of 5 resident files reviewed contain updated Physician Report and Needs and Services Plan. Additionally, resident files contain at least the following: Admission Agreement, Centrally Stored Medication Records, Weight Records, Emergency Information, and Consent Forms. LPA discovered 1 of 5 residents' medical assessment was signed by a Nurse Practitioner (NP). A technical advisory was provided to obtain a waiver request from the Department. LPA also reviewed resident medications for regulatory compliance. No issues were noted at this time. LPA conducted staff and resident interviews. Facility’s liability insurance is current per regulatory requirements. LPA reviewed facility’s disaster plan to ensure regulatory compliance. LPA observed that facility conducts quarterly fire drills. Last drill conducted was on 4/5/24. LPA was provided current copy of facility's LIC 308, LIC 500, and liability insurance. The following deficiencies were observed (see LIC 809D) and cited from the California Code of Regulations, Title 22. Failure to correct deficiencies may result in civil penalties. An exit interview was conducted with Aida Gatchalian and Maria Magnolia Tolon, and a copy of this report and appeal rights were provided.