Routine inspection·March 8, 2024

Licensing Program Analyst (LPA) Magda Malcore made an unannounced visit to the facility to conduct a required annual inspection. LPA met with Melly Kwik, Facility Representative and discussed the purpose of the visit. The facility is a Residential Care Facility for the Elderly (RCFE) with a license capacity of (6), a current census of (5) residents, and a hospice waiver for (4). 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. Indoor activity areas are sufficient for residents in care. Outdoor shaded area is sufficient for resident activities and is enclosed with a self-latching gate. The facility has sufficient lighting and is maintained at a comfortable temperature. Resident’s showers, toilets, and hand washing areas were operating in a safe and sanitary condition. The hot water temperature in residents' bathrooms measured 106 degrees F. Four (4) resident’s bedrooms had sufficient lighting and furniture in good repair. Facility has operating carbon monoxide/fire alarm system, laundry equipment and telephone service. The facility has sufficient 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, Theft and Loss policy, facility license, disaster emergency plan and telephone numbers. Sharps were kept locked and inaccessible to residents in care. Care & Supervision : Facility has 24-hour, 7 days a week care staff. Food Service: The facility has sufficient non-perishable and perishable food supply for residents in care. The facility has sufficient cups, plates, utensils, and dining space for resident in care; however, LPA observed the facility's range hood above the stove was not maintained cleaned as it was saturated with grease. Deficiency cited. Record Review: The facility’s Administrator’s certification and liability insurance are current. LPA staff record review reveals, staff #1 (S1) did not have documentation of CPR/first aid training. LPA resident record review reveals, resident #1 (R1's) Physician's report was missing physician's signature. In addition, the facility did not have record of a drill conducted with staff for review. Deficiencies cited. Medical Related Services : Resident’s medications are labeled and centrally stored in a locked cabinet. Based on observations and record review, deficiencies are being cited per Title 22, of the California Code of Regulations and Health and Safety Code. An exit interview was conducted where the Licensing Reports were discussed with the facility representative. Copies of the report with Appeal Rights was provided to the facility representative at the conclusion of the visit.