Routine inspection·December 12, 2023

Licensing Program Analyst (LPA) Anna Bueno made an unannounced visit to conduct a required annual inspection. LPA was greeted by licensee Ruth Chernovsky who was informed of the purpose of the visit. LPA and licensee toured the interior and exterior of the facility. Physical Plant and Safety of Environment/Operational Requirements: LPA observed a fenced pool area with a locked gate. LPAs observed the facility to be clean and in good repair. The home is maintained at a comfortable temperature for the residents. Lighting is sufficient for safety and comfort. Water temperature measured to be comfortable for residents. Laundry facilities and locked cabinets were present for storing laundry soap and other chemicals. Fire extinguishers are charged and last inspected on 02/03/23. All outdoor and indoor passageways are free of obstruction. A locked area is provided for medications and sharp objects. There is a working telephone at this location. The LIC 610E, emergency disaster plan is maintained. The facility has a current written definitive plan of operation. The facility is maintained in conformity with the regulations adopted by the state fire marshal. Personnel Records/Training/and Staffing-. LPA reviewed employee records for fingerprint clearance, personnel/job application, health screening and TB test results, criminal record statement, employee rights, training verification, and current administrator certification. LPA did not observe current first aid certification, certifications expired in 2021. This poses a potential health and safety concern for clients in care. Resident Records/Incident Reports/Personal Rights/Residents with Special Needs/Incidental Medical and Dental: LPA reviewed resident records and found that they contained records including, admission agreement, medical assessment and TB test results, consent forms, identification and emergency information, appraisal needs and service plans, safeguard for personal property/valuables, and personal rights notification. The facility is meeting documentation requirements. Resident Rights are posted in the facility and a copy is signed on file. During the visit, facility staff completed the centrally stored medication. LPA did not observe necessary records for PRN medication and administration. This poses a potential health and safety risk to clients in care. Food Service: LPA Bueno was present during dinner time. LPA observed the meal is adequate to meet the nutritional needs of the residents, including a service of vegetables, protein, and scalloped potatoes. Food prep areas are clean and organized. Food supply meets the requirement of one week supply of nonperishable and 2-day supply of perishables food on hand. LPA Bueno made observation throughout the inspection process to assess if the facility remains in conformity with the State Fire Marshall regulations. The facility has not exceeded its capacity limitation and the structure remains unchanged according to the approved floor plan. Smoke detectors were tested by Licensee Chirnovsky while LPA Bueno tested the bedroom hallways carbon monoxide detectors. All units were found to be operational. Based on the information received during this visit today, the following deficiencies are being cited per Title 22, Division 6 of The California Code of Regulations. Refer to LIC 809D for cited deficiencies. This report and LIC 809D were reviewed with and a copy provided to the facility representative. Appeal Rights were also provided at the time of the exit interview.