Routine inspection·July 28, 2022

Licensing Program Analyst (LPA) Ruth Wallace conducted an unannounced Required 1 Year Annual Inspection visit. LPA met with Executive Director (ED) and explained to him the purpose of today's visit. Administrator Certificate Expires 11/19/2023. There are currently 52 residents who reside at this facility. This facility has a hospice wavier for 15 and currently has 5 residents on Hospice and 6 on Home Health. This facility has 6 different cottages. 3 serving as Assisted Living and 3 serving as Memory Care. LPA toured all 6 cottages with ED. LPA observed with ED each cottage with a dining area and a medication room. Facility roster indicated Birch cottage has 13 residents. Facility roster indicated Aspen cottage has 14 residents. Cedar is currently vacant for remodeling. Dogwood is vacant. Facility roster indicated Elm cottage has 11 residents. Facility roster indicated Fir has 13 residents. LPA observed toxins and medications locked in all cottages with residents. LPA conducted a sample medication audit in several cottages. LPA spot checked several resident rooms in each cottage occupied. All rooms were found to be odor free. LPA observed sufficient 2+day perishable and 7+day non-perishable food and observed locked sharps in the kitchen and locked toxins in the laundry area. LPA observed the smoke/monoxide alarms to be in working order and the fire extinguishers are fully charged which expire 2/15/2023. Facility is conducting quarterly fire drills and the last one was conducted 06/27/2022. The hot water measured 108.2*F which is within the required range of 105-120*F. A review of (5) facility resident records was conducted and all have required documents for Community Care Licensing (CCL). A review of (7) facility personnel records was conducted. All staff are fingerprint cleared and associated to the facility. All staff have current First Aid certifications on file. Facility is conducting initial and continuing training as required. LPA observed the following posted on the facility wall: Facility license, sketch, See Something Say Something poster, Ombudsman poster, Theft and Loss Policy, Resident Bill of Rights, Rights of Resident/Family Councils. There were no deficiencies cited from California Code of regulations, Title 22 found during today’s inspection. Exit interview conducted with Executive Director and a copy of report left at facility.