Routine inspection·January 13, 2025

Licensing Program Analyst (LPA) Magda Malcore made an unannounced visit to the facility to conduct a required annual inspection. LPA met with Administrator Gloria Anne Mangangey and discussed the purpose of the visit. The facility is a 3 bedroom, 3 bathroom, Residential Care Facility for the Elderly (RCFE) with a license capacity of (6) and a current census of (3) residents in care. LPA conducted an overall inspection of the facility, which included, but was not limited to, the following: Physical Plant/Environment: Indoor and outdoor passageways are free of obstruction. The facility has no swimming pools or similar bodies of water. Outdoor shaded area is sufficient for resident activities and is enclosed with a self-latching gate. LPA observed saws and tools in an unlocked outdoor shed. The facility has sufficient lighting, books, magazines, games, and activity space for residents. The facility is maintained at 72 degrees F. Resident’s bathrooms equipment were fully operational and bathrooms were equipped with grab rails and slip mats. The hot water temperature in residents' bathrooms measured 105 degrees F. The facility maintains an operating night light in hallway leading to central bathroom. Resident’s bedrooms audited had sufficient lighting, bed linen and furniture in good repair. The facility is equipped with carbon monoxide alarms, fully charged fire extinguishers, laundry equipment, signal system and telephone service. The facility has sufficient bed linen, towels, and personal hygiene items for residents. The facility has posted in a common area, Community Care Licensing complaint poster, Ombudsman poster, Personal Rights, facility license, disaster evacuation plan and emergency telephone numbers. Sharp knives and scissors were kept lock. LPA observed disinfectant and insecticide sprays were stored unlocked in the bathroom located near the kitchen area. LPA observed disinfectant cleaning wipes on bathroom counter in bedroom #1, accessible to residents in care. Food Service: Facility kitchen and dining areas are maintained clean. The facility has sufficient non-perishable and perishable food supply for residents in care. The facility has sufficient clean cups, plates, and utensils for residents use. Care & Supervision : Facility has 24-hour, 7 days a week care staff. Staff working have criminal records clearances through the Department. Record Review: The facility's Administrator certification and liability insurance is current. Staff files reviewed were observed to be complete. Review of resident files reveals resident #1 (R1) and resident #2 (R2) did not have a reappraisal conducted within the last 12 months. Medical Related Services : Resident’s medications are centrally stored in a locked cabinet. The facility has a complete first aid kit with manual. LPA observed R1, R2, and resident#3 (R3)'s pm medication was missing from the bubble packet. Staff stated that the medication was removed from the packet and showed LPA the medication was stored in a small plastic container. LPA observed R3's insulin pin was kept in plastic bag separated from its original prescription packaging. Based on observations and record review, deficiencies are being cited and technical advisories were issued per Title 22, of The California Code of Regulations. This report and correction plans were reviewed with the Administrator and copies with Appeal Rights were provided at the conclusion of the visit.