Routine inspection·February 20, 2024

Licensing Program Analyst, Amber Coleman, (LPA) arrived at the Mountain View Cottages - VI unannounced to conduct an Annual Inspection. LPA knocked on the door and was greeted by Caregiver, Mijo Suzuki. LPA introduced self and stated purpose of the visit. LPA was granted entry and signed in. LPA was informed that the current census is 1. Other residents in care had been picked up and taken to their day programs. LPA was provided a place to work then accompanied by Staff on a walk through of the facility. The facility is comprised of, six (6) Bedrooms, 2 Bathrooms, Living Room, Den, Office Space, Kitchen, Backyard and attached garage. The facility is a Residential Care Facility Elderly. The facility also maintains partnership with the Inland Regional Center at Level 4I. Facility is approved for 6 non-ambulatory, 1 bedridden and Hospice Waiver approval for 2 residents. The facility is operating in the capacity approved by Community Care Licensing (CCL). Physical Plant: The facility is maintained in comfortable temperature. Sufficient lighting was provided throughout the facility by various lamps, light fixtures and night-lights. Pathways were free of obstruction and clutter. Smoke detectors and carbon monoxide alarms were observed throughout the facility. They were tested and found operational. A fully charged fire extinguisher was located in the kitchen; last inspection date February 2024. Resident rooms all contained adequate furniture such as: beds with required linens, adequate storage space, seating and sufficient lighting. At approximately 10:40 am LPA observed a yellow colored bottle of pledge sitting unattended in a Resident Room. Staff secured the bottle of pledge upon observation. Extra linens and hygiene supplies were stored in a hallway closet. The hallway lead to the facility's laundry room and attached garage. LPA observed that the garage door was secure. Laundry room also contained secure cabinetry for laundry supplies. Please see LIC809-C Bathrooms contained operational appliances, handrails, non-slip materials and adequate paper supplies. Both dining rooms, den and living rooms provide adequate seating for residents, guests and visitors. Activity materials were observed in each common space. Food Service: LPA observed the facility kitchen, which contained operable appliances and sufficient dishware, cups, and utensils for residents in care. The facility food supply was observed to have sufficient amounts of both non-perishable and perishable foods. Inside the facility refrigerator. LPA observed fresh fruit and vegetables, beverages, milk, breads, cheese, frozen meats and meals. Chemicals and Sharp objects were observed in secure locations inaccessible to residents in care. Water temperature was tested in the kitchen and measured between 100 and 104 degrees. Emergency supply of food, water, additional PPE, and supplies were observed in the attached garage. Adjacent to the kitchen stands a secure cabinet for Resident Medications and files. Signs and Posters: LPA observed the following posters in prominent places throughout the facility. Posters such as: Long Term Care Ombudsman, Resident Council, Resident Rights, House Rules, Facility Sketch/Evacuation Plan, Labor Laws, SEE/SAY, Food Menu, Activities Calendar, Infection Control and Facility License. Record Review: LPA reviewed resident files for Admission's Agreements, Appraisals, Needs and Services, IPPs and Physician's Report. LPA requested staff records/files. Administrator arrived shortly after request to provide LPA with staff records. Staff records reviewed contained current Health Screenings, Personnel Records, Criminal Background, Fingerprints, CPR/1st Aid and annual required training. Based on observations, interviews and record reviews no deficiencies will be cited per Title 22, California Code of Regulations. A technical violation will be issued to address an above mentioned concern. An exit interview was conducted where this report was reviewed, discussed, then provided to Facility Representative.