Routine inspection·January 8, 2025

Licensing Program Analyst (LPA) Magda Malcore made an unannounced visit to the facility. The purpose of the visit was to conduct a required comprehensive annual inspection. LPA met with Administrator Jin Wang and informed the purpose of the visit. The facility is an 8 bedroom, Residential Care Facility for Elderly (RCFE) facility. The facility's license capacity is (18) with a current census of (9) . LPA conducted a general inspection of the facility, which included, but was not limited to, the following: Physical Plant: The facility has no obstructions to indoor and outdoor passageways. The facility is maintained at a 75 degrees F. The facility's outdoor activity area is enclosed with latching gate. The facility is equipped with operating smoke/carbon monoxide alarms, telephone service, and call button system. The facility has posted Community Care Licensing Complaint poster, Ombudsman poster, emergency telephone numbers, facility menu, activities, theft and loss policy, and "Oxygen in use" signs. Cleaning supplies, toxins, and sharps were kept inaccessible to residents in care. LPA inspected five (5) resident bedrooms which were equipped with beds, bed linen, night stands and sufficient lighting. LPA inspected five (5) resident bathrooms which were equipped with grab rails and slip mats. LPA observed the bathroom hot water temperature in the following bedrooms tested as follows: bedroom#103 tested 132 degrees F, bedroom#104 tested 139 degrees F, bedroom #107 tested 133 degrees F, and bedroom #106 tested at 139 degrees F. Deficiency cited. Food Service: Non-perishable and perishable food supply is sufficient for number of residents in care. The facility's two (2) refrigerators were operating properly at 43 degrees F. Care & Supervision: The facility's staff schedule reflects care staff coverage 24 hours a day, 7 days a week. All staff members working in the facility have criminal record clearance through the department. Record Review: LPA reviewed three (3) resident files for admission agreements, physician reports, assessments, needs and services plans. LPA reviewed three (3) staff files for First Aid/CPR certifications, criminal record clearances, trainings, and health screenings. Resident medications were kept inaccessible to residents in care. LPA review of resident #1 (R1), resident #2 (R2) , resident #3 (R3) medication records reveals staff did not document on 1/7/25 when the medication was given for all three residents. Deficiency cited. Deficiencies were cited and technical advisories were issued per Title 22, Division 6, of the California Code of Regulations. An exit interview was conducted, where reports (LIC809, LIC809-C, LIC809-D, LIC9102) and were discussed. Copies of the reports were provided with appeal rights to the Administrator at the conclusion of the visit.