Routine inspection·December 4, 2024

Licensing Program Analyst (LPA) Michelle Echeverria made an unannounced visit to the facility. The purpose of the visit was to conduct a required comprehensive annual inspection. LPA met with Caregiver, Maribel Barnes and was granted entry to the facility. LPA was accompanied by Maribel to conduct a general overall inspection, which included, but was not limited to, the following: The facility has 5 bedrooms, 3 bathrooms, kitchen, dining area, living room, office area, laundry room, garage and backyard. LPA completed a walk through of facility, review of records and medication audit. Physical Plant: The facility is operating in the capacity approved by Community Care Licensing (CCL). There are no obstructions to indoor and outdoor passageways. The facility is maintained at a comfortable temperature of 68 degrees fahrenheit. LPA inspected resident bedrooms; they are equipped with required furniture such as: mattresses, night stands, storage space, chairs and sufficient lighting. LPA observed that the couple bedroom did not have an appropriate sized bed. Deficiency issued. LPA inspected resident bathrooms; bathrooms were clean and appliances were found functional. Water temperatures tested at 123 degrees fahrenheit. The facility is equipped with operational smoke detectors, carbon monoxide alarms, charged fire extinguisher, and first aid kit. Posters such as; the personal rights, CCL complaint poster, ombudsman, and license were posted in a common area. Cleaning supplies, toxins, sharps, medications and other dangerous items were kept in secure cabinets inaccessible to residents. LPA observed that the facility did not have sanitary pads. Deficiency issued. Residents/Staff files were observed locked and made inaccessible. There are no bodies of water, firearms or ammunition in the facility. LPA observed two broken window screens, a broken air conditioner and window bars in one of the resident's bedroom upstairs. Deficiency issued. Food Service : LPA observed 2 days of perishables and 7 days non-perishables food, pantry stocked and up to date. Dishes, cups, and utensils were stored properly. Yards/Outside: One shaded patio, two sheds used for storage and a side gate with self-latching handle on the left side of the house that leads into the backyard. All outdoor pathways were free of obstructions. Care & Supervision: LPA observed that the facility did not have sufficient staff present and the schedule was not followed accordingly. Deficiency issued. Record Review: LPA reviewed resident files for admission agreements, updated physician reports, and needs and services plans. LPA observed issues on the residents records like admission agreements not acknowledged by the residents or responsible party, LIC602 not updated annually according to the resident's diagnosis, and appraisals not reevaluated. Deficiency issued. LPA also reviewed staff files for First Aid/CPR certification, criminal record clearance, trainings, and health screenings. Medication was audited and matched with record. LPA reviewed the liability insurance, emergency disaster plan and disaster drills. LPA observed that the facility is not performing the activities scheduled. Deficiency issued. Deficiencies were cited during this visit. An exit interview was conducted where this report LIC809, LIC809C, LIC809D and appeal rights were discussed and copies were provided to Assistant Administrator, Ahmad Abdallatef who arrived in the middle of the tour.