Routine inspection·May 7, 2025

Licensing Program Analyst (LPA) LaVette Farlow, arrived unannounced at Walnut Senior Home III, to conduct an annual inspections. LPA was greeted by licensee, Gulvarg Kaur. LPA introduced self and stated purpose of the visit. The facility is licensed to house (6) non-ambulatory residents and hospice waiver/granted for six (6) residents. LPA toured the facility inside and outside and observed the following: Physical Plant: Facility is a one story house with (4) resident bedrooms, (2) resident bathrooms, office/staff room, living room, dining area, kitchen, pantry, backyard, and attached garage. LPA observed the facility's temperatures to be comfortable and measured at 75 degrees Fahrenheit. LPA observed the hot water temperature in the kitchen, common area bathrooms and residents bathrooms. The water temperature in the residents bathroom and common area bathrooms measured at 108.5, and 108, which is within regulations. LPA observed bathrooms and found that showers and toilets are operable. Each bathroom contained adequate amounts of hand hygiene and paper products. LPA observed that linens and hygiene items are enough for residents in care. Each resident room included lamps, night-lights dresser drawers, bedding and chairs and appropriate lighting to ensure residents comfort and safety. The facility is equipped with smoke alarms and carbon monoxide detectors. The facility maintains and conducts fire drills and earthquake drills quarterly. Last drill completed in 3/2025. No abnormal notes (LIC809C Continued) made. Fire Extinguishers were observed throughout the facility. Fire Extinguishers were last inspected November 2024. Food Service: Nonperishable and perishable food items observed were sufficient for number of residents in care. Food is being prepared and stored properly. Facility offers a variety of food options and snacks for residents. Staff maintain a food menu which is updated on a monthly basis. Care & Supervision : Facility keeps, toxins, sharps, and other hazardous items secured and inaccessible to residents in care and stored in a closets throughout the facility. Record Review and Resident/Staff Files: LPA reviewed records for three (3) residents files currently living at the facility. Resident records are complete with updated physician reports, Needs and Services Plans, Admission Agreement, and Emergency Contact sheet. LPA additionally reviewed three (3) staff files and three (3) out of (3) staff records reflect current CPR/First Aid Certification, Criminal Record Clearance, Health Screening Report, and TB test. Administration: Disaster Plan, Ombudsman poster, Administrator Certificate, and facility license are posted in a prominent place. Emergency Disaster Plan is current. Facility files are maintained in secure locations in the facility. Medication/Medical Related Services: LPA observed that the residents' medication is centrally stored and locked in the staff office. LPA observed that 1 out of 3 resident MAR was missing medication or not properly logged for 2 prescriptions. A deficiency was cited. Based on observations, one deficiency cited per Title 22, California Code of Regulations. An exit interview was conducted and copy of this report reviewed and discussed, then provided to Administrator, Gulvarg Kaur.