Routine inspection·May 2, 2024

Licensing Program Analyst (LPA) Magda Malcore made an unannounced visit to the facility to conduct a required annual inspection. LPA met with Judy Swanson, Licensee, 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 in care and a hospice waiver for (2). 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.The facility has sufficient lighting and is maintained at a comfortable temperature. The facility has operating carbon monoxide alarms and telephone service. Resident’s showers, toilets, and hand washing areas were operating in a safe and sanitary conditions. The hot water temperature in both resident bathrooms measured 107 degrees F. Four (4) resident’s bedrooms had beds, bed linen, chairs, storage space and sufficient lighting. 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, facility license, disaster evacuation plan and emergency telephone numbers. Food Service: Facility kitchen and dining areas are maintained clean. The facility has sufficient non-perishable and perishable food supply for residents in care. Sharps, disinfectants, and cleaning solutions were kept locked and inaccessible to residents in care. Care & Supervision : Facility has 24-hour/7days a week care staff. Facility staff have current CPR/first aid training. Medical Related Services : Resident’s medications are labeled and centrally stored in a locked cabinet. The facility sufficient first aid supplies. Record Review: The Licensees' Administrator's certification is current. The facility’s last fire drill was conducted on 4/6/24. Staff files reviewed were observed to be complete. LPA review of (5) resident files reveals, resident #1 (R1) did not have a preadmission appraisal on file for review. Based on observations and record review, technical violations and a deficiency is being cited per Title 22, of The California Code of Regulations. This report and a plan of correction addressed in report LIC809-D was reviewed with the Licensee. Copies of the licensing reports were provided with Appeal Rights to the Licensee at the conclusion of the visit.